Provider Demographics
NPI:1275387755
Name:SUSAN DANIEL OPTOMETRY CONSULTING, APC
Entity Type:Organization
Organization Name:SUSAN DANIEL OPTOMETRY CONSULTING, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:DANIEL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-807-2338
Mailing Address - Street 1:6472 WAYFINDERS CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-4075
Mailing Address - Country:US
Mailing Address - Phone:760-807-2338
Mailing Address - Fax:760-434-5624
Practice Address - Street 1:6472 WAYFINDERS CT
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-4075
Practice Address - Country:US
Practice Address - Phone:760-807-2338
Practice Address - Fax:760-434-5624
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty