Individual
ALEXANDRIA TILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
102 CARTIER AISLE, IRVINE, CA 92620-5715
(949) 533-0628
Mailing address
102 CARTIER AISLE, IRVINE, CA 92620
(949) 533-0628
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TUV008457
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OPTOMETRY LICENSE
TUV008457
NY
Enumeration date
08/28/2016
Last updated
08/28/2016
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