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CORY BREAM O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1053468439

Individual Registrant:
 CORY  BREAM O.D.
Gender: F
Sole Proprietor

Location and contact information for practice:
7095 MARKET PLACE DR  GOLETA, CA 93117-5905 US
Tel: 805-562-1300  Fax: 805-562-1301

Contact information for business:
3635 SANTA MARIA LN  SANTA BARBARA, CA 93105-3227 US
Tel: 805-562-1300  Fax: 805-562-1301

Registration Information:
NPI: 1053468439
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
CA101071T

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
TAX ID33-0646638CA01
MEDICALSD0101710CA01




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