Provider Demographics
NPI:1619146800
Name:DR DEBBIE M GOYA O D AND DR JANIS L MAYEDA O D INC
Entity Type:Organization
Organization Name:DR DEBBIE M GOYA O D AND DR JANIS L MAYEDA O D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JANIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYEDA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-327-4878
Mailing Address - Street 1:2202 W ARTESIA BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90504-2963
Mailing Address - Country:US
Mailing Address - Phone:310-327-4878
Mailing Address - Fax:310-327-0467
Practice Address - Street 1:2202 ARTESIA BLVD STE A
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90504-2963
Practice Address - Country:US
Practice Address - Phone:310-327-4878
Practice Address - Fax:310-327-0467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10514T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty