Organization
17TH STREET OPTOMETRY APC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER ELSON OD (OPTOMETRIST)
(949) 338-7027
Entity
Organization
Contact information
Practice address
17300 17TH ST STE M, TUSTIN, CA 92780-1955
(714) 838-9664
(714) 838-6774
Mailing address
17300 17TH ST STE M, TUSTIN, CA 92780-1955
(714) 838-9664
(714) 838-6774
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
152WX0102X
Occupational Vision Optometrist
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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