Provider Demographics
NPI:1093918435
Name:HUMMELMAN, LENORE CAROLINE (OD)
Entity Type:Individual
Prefix:DR
First Name:LENORE
Middle Name:CAROLINE
Last Name:HUMMELMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:330 OXFORD ST STE 214
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-3119
Mailing Address - Country:US
Mailing Address - Phone:619-420-3010
Mailing Address - Fax:619-420-4123
Practice Address - Street 1:330 OXFORD ST STE 214
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-3119
Practice Address - Country:US
Practice Address - Phone:619-420-3010
Practice Address - Fax:619-420-4123
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10764TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist