Provider Demographics
NPI:1174004212
Name:PARAMOUNT FAMILY OPTOMETRY
Entity Type:Organization
Organization Name:PARAMOUNT FAMILY OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JESUS
Authorized Official - Middle Name:RAMON
Authorized Official - Last Name:MERINO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:562-633-6046
Mailing Address - Street 1:14905 PARAMOUNT BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-3440
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:14905 PARAMOUNT BLVD STE E
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-3440
Practice Address - Country:US
Practice Address - Phone:562-633-6046
Practice Address - Fax:562-633-0260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-27
Last Update Date:2020-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty