Paul J Super OD a Professional Corporation
Paul J Super OD a Professional Corporation is an Optometrist in Los Angeles, California. Licensed in California. Registered with an NPI since 2009.
- Licensed in
- CA
- In the registry since
- 2009
- Specialties on file
- 6
Practice location Address checks out
11777 San Vicente Blvd #130Los Angeles, CA 90049-5011
Phone: (310) 820-2020
Fax: (310) 820-1884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Optometrist (primary) | Taxonomy 152W00000X · Licence OP8867TPG (CA) |
|---|---|
| Corneal and Contact Management Optometrist | Taxonomy 152WC0802X · Licence OP8867TPG (CA) |
| Low Vision Rehabilitation Optometrist | Taxonomy 152WL0500X · Licence OP8867TPG (CA) |
| Pediatric Optometrist | Taxonomy 152WP0200X · Licence OP8867TPG (CA) |
| Vision Therapy Optometrist | Taxonomy 152WV0400X · Licence OP8867TPG (CA) |
| Health Maintenance Organization | Taxonomy 302R00000X · Licence OPT8867T (CA) |
Record details
| NPI number | 1457681371 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Paul Super — Optometrist · (310) 820-2020 |
| NPI enumerated | December 29, 2009 |
| Last updated in NPPES | March 3, 2016 |
| Mailing address | 11777 San Vicente Blvd, 130, Los Angeles, CA 90049-5011 |
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