Organization
NUEVA VISION OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANTONIO ANTONIO BUSTAMANTE SR. (OPTICIAN)
(310) 604-3851
Entity
Organization
Contact information
Practice address
3100 E IMPERIAL HWY, SUITE # 1109, LYNWOOD, CA 90262-3202
(310) 604-3851
(310) 878-0301
Mailing address
3100 E IMPERIAL HWY, SUITE # 1109, LYNWOOD, CA 90262-3202
(310) 604-3851
(310) 878-0301
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
2945
CA
Other
Enumeration date
11/19/2012
Last updated
11/19/2012
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