Individual
DR. EFRAIN MASCARENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
440 4TH AVE, CHULA VISTA, CA 91910-4443
(619) 427-2020
Mailing address
440 4TH AVE, CHULA VISTA, CA 91910-4443
(619) 427-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10906
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0109061
—
CA
Enumeration date
08/12/2008
Last updated
04/17/2013
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