Organization
LOEW VISION OPTOMETRIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL J. SUPER O.D. (PRESIDENT)
(310) 500-8867
Entity
Organization
Contact information
Practice address
239 S LA CIENEGA BLVD, SUITE 100, BEVERLY HILLS, CA 90211-3328
(310) 553-0100
(424) 288-4893
Mailing address
239 S LA CIENEGA BLVD, SUITE 100, BEVERLY HILLS, CA 90211-3328
(310) 553-0100
(424) 288-4893
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
152W00000X
Optometrist
—
—
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
—
—
225XL0004X
Low Vision Occupational Therapist
—
—
Other
Enumeration date
12/01/2011
Last updated
12/01/2011
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