Organization
BYRON M FENNEMA O.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BYRON MUNEHIRO FENNEMA O.D. (OWNER)
(714) 997-1091
Entity
Organization
Contact information
Practice address
1234 W CHAPMAN AVE, SUITE 201, ORANGE, CA 92868-2862
(714) 997-1091
(714) 547-8279
Mailing address
1234 W CHAPMAN AVE, SUITE 201, ORANGE, CA 92868-2862
(714) 997-1091
(714) 547-8279
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT5522TPA
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0055220
—
CA
Enumeration date
05/26/2006
Last updated
08/22/2020
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