Individual
DR. COLIN SIMMONS FUNNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1445 DONLON ST STE 12, VENTURA, CA 93003-8390
(805) 642-3777
(805) 644-6491
Mailing address
1445 DONLON ST STE 12, VENTURA, CA 93003-8390
(805) 624-3777
(805) 644-6491
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34354TLG
CA
152WC0802X
Corneal and Contact Management Optometrist
34354TLG
CA
152WP0200X
Pediatric Optometrist
34354TLG
CA
152WV0400X
Vision Therapy Optometrist
34354TLG
CA
Other
Enumeration date
08/27/2019
Last updated
08/27/2019
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