Provider Demographics
NPI:1164079562
Name:DOCTORS MATTHEW ALPERT AND JOSHUA CORBEN OPTOMETRIC CORP
Entity Type:Organization
Organization Name:DOCTORS MATTHEW ALPERT AND JOSHUA CORBEN OPTOMETRIC CORP
Other - Org Name:WINK OPTOMETRY OF WESTLAKE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORBEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:661-259-2168
Mailing Address - Street 1:2867 AGOURA RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-3218
Mailing Address - Country:US
Mailing Address - Phone:805-492-2448
Mailing Address - Fax:
Practice Address - Street 1:2867 AGOURA RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-3218
Practice Address - Country:US
Practice Address - Phone:805-496-2448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-20
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty