Organization
MANHATTAN BEACH VISION GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN WALTER FUNNELL OD (OWNER)
(310) 545-4585
Entity
Organization
Contact information
Practice address
946 MANHATTAN BEACH BLVD, MANHATTAN BEACH, CA 90266-5120
(310) 545-4585
(310) 546-3240
Mailing address
946 MANHATTAN BEACH BLVD, MANHATTAN BEACH, CA 90266-5120
(310) 545-4585
(310) 546-3240
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPT6029
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LICENSE
OPT6029
CA
Enumeration date
04/06/2007
Last updated
08/22/2020
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