Provider Demographics
NPI:1154833200
Name:DR. STEFIE RIBEIRO O.D, PROF. CORP
Entity Type:Organization
Organization Name:DR. STEFIE RIBEIRO O.D, PROF. CORP
Other - Org Name:PERSPECTIVE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIBEIRO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-564-9944
Mailing Address - Street 1:46660 WASHINGTON ST STE 3
Mailing Address - Street 2:
Mailing Address - City:LA QUINTA
Mailing Address - State:CA
Mailing Address - Zip Code:92253-2451
Mailing Address - Country:US
Mailing Address - Phone:760-564-9944
Mailing Address - Fax:
Practice Address - Street 1:46660 WASHINGTON ST STE 3
Practice Address - Street 2:
Practice Address - City:LA QUINTA
Practice Address - State:CA
Practice Address - Zip Code:92253-2451
Practice Address - Country:US
Practice Address - Phone:760-564-9944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-30
Last Update Date:2018-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14851152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty