Provider Demographics
NPI:1477575272
Name:ALPERT, TERI LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:TERI
Middle Name:LYNN
Last Name:ALPERT
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:28601 MARGUERITE PKWY
Mailing Address - Street 2:STE 3
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3726
Mailing Address - Country:US
Mailing Address - Phone:949-364-0891
Mailing Address - Fax:949-666-5149
Practice Address - Street 1:28601 MARGUERITE PKWY
Practice Address - Street 2:STE 3
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3726
Practice Address - Country:US
Practice Address - Phone:949-364-0891
Practice Address - Fax:949-666-5149
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7116T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0217340001Medicare NSC
CABT888AMedicare PIN