Individual
TIMOTHY LAWRENCE HENNINGS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
80 HUNTINGTON ST SPC 313, HUNTINGTON BEACH, CA 92648-5344
(714) 766-9799
Mailing address
80 HUNTINGTON ST SPC 313, HUNTINGTON BEACH, CA 92648-5344
(714) 766-9799
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SLD5989
CA
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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