Sofia Bernabe

Individual provider Active NPI Optometrist · Carson, CA

NPI 1811421985 · NPPES record last updated Apr 16, 2017

Key facts

NPI
1811421985
Entity type
Individual (NPI type 1)
Primary specialty
Optometrist 152W00000X
License
33348 (CA)
Practice address
20700 Avalon Blvd Ste 343
Carson, CA 90746-3716
Phone
(310) 532-2622
NPI assigned
Apr 16, 2017
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
William K. Shiomi, O.D., Inc Optometrist Past
since Feb 12, 2014
Accepting new patients
Alina Ho OD a Professional Corp Optometrist Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 33348 CA Yes

Addresses

Primary practice location

20700 Avalon Blvd Ste 343
Carson, CA 90746-3716

Mailing address

20700 Avalon Blvd Ste 343
Carson, CA 90746-3716
Phone (310) 532-2622

Other providers in Carson, CA

All providers in Carson, CA · Optometrist in California

Sources for this page

Verify at the official NPI Registry.