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MRS. DIANA ISABEL IRAHETA O.D

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1932205226

Individual Registrant:
MRS. DIANA ISABEL IRAHETA O.D
Gender: F
Sole Proprietor

Location and contact information for practice:
30668 BENTON RD # B-101  WINCHESTER, CA 92696 US
Tel: 951-926-4411  Fax: --

Contact information for business:
40386 AMESBURY LN  TEMECULA, CA 92591-4432 US
Tel: 310-259-5310  Fax: --

Registration Information:
NPI: 1932205226
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
CAOPT 13168

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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