Provider Demographics
NPI:1497295513
Name:KAREN LOVE, OD, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KAREN LOVE, OD, A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:760-743-6540
Mailing Address - Street 1:1299 E PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92027-3027
Mailing Address - Country:US
Mailing Address - Phone:760-743-6540
Mailing Address - Fax:760-743-4164
Practice Address - Street 1:1299 E PENNSYLVANIA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92027-3027
Practice Address - Country:US
Practice Address - Phone:760-743-6540
Practice Address - Fax:760-743-4164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA12331T152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty