Individual
DR. BRENT KENJI MITSUUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1280 S VICTORIA AVE STE 100, VENTURA, CA 93003-6550
(805) 650-9922
Mailing address
1280 S VICTORIA AVE STE 100, VENTURA, CA 93003-6550
(805) 650-9922
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10380T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2371
MEDICAL EYE SERVICES INS#
CA
Enumeration date
03/06/2007
Last updated
10/01/2012
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