Provider Demographics
NPI:1396403119
Name:GERMANY OPTOMETRY
Entity Type:Organization
Organization Name:GERMANY OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JUNG
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:213-265-8946
Mailing Address - Street 1:3130 W OLYMPIC BLVD STE 180
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2661
Mailing Address - Country:US
Mailing Address - Phone:323-735-2000
Mailing Address - Fax:
Practice Address - Street 1:3130 W OLYMPIC BLVD STE 180
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2661
Practice Address - Country:US
Practice Address - Phone:323-735-2000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-30
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty