Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 33484 | CA |
NPI | 1013369511 |
---|---|
Provider Name | Cristen Adams |
First Address | Los Angeles, CA 90057-5418 |
Second Address | Hollywood, CA 90028-5309 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2016 |
Last Update Date | 10/10/2016 |