Organization
2020 LENS OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARVIN ROMEO MARTINEZ OPTICIAN (OPTICIAN)
(562) 261-7542
Entity
Organization
Contact information
Practice address
12345 MOUNTAIN AVE, SUITE X, CHINO, CA 91710-2783
(909) 628-4222
(909) 628-6555
Mailing address
12345 MOUNTAIN AVE, SUITE X, CHINO, CA 91710-2783
(909) 628-4222
(909) 628-6555
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
37867
CA
Other
Enumeration date
11/07/2012
Last updated
11/07/2012
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