Individual
DR. ALEXIS MAKIKO MCCULLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4353 LA JOLLA VILLAGE DR STE H-20, SAN DIEGO, CA 92122-1242
(858) 622-2165
Mailing address
2556 CHICAGO ST UNIT 28, SAN DIEGO, CA 92110-4161
(310) 480-0216
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34810
CA
Other
Enumeration date
07/05/2021
Last updated
07/05/2021
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