Individual
HECTOR CARRILLO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1120 W LA VETA AVE STE 100, ORANGE, CA 92868-4215
(714) 509-4490
Mailing address
15021 ELMBROOK DR, LA MIRADA, CA 90638-4702
(562) 305-7539
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
35503
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35503
CALIFORNIA OPTOMETRY BOARD
CA
Enumeration date
12/08/2022
Last updated
11/05/2024
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