Individual
ALYSSA TERESA PACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
890 EASTLAKE PKWY STE 102, CHULA VISTA, CA 91914-4521
(619) 216-3937
Mailing address
1132 MANSIONES LN, CHULA VISTA, CA 91910-7914
(619) 632-7332
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34608
CA
Other
Enumeration date
08/08/2020
Last updated
08/08/2020
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