Provider Demographics
NPI:1891760716
Name:WERNER, REX ARTHUR (OD)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:ARTHUR
Last Name:WERNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2650 JAMACHA RD
Mailing Address - Street 2:SUITE 155
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92019-4319
Mailing Address - Country:US
Mailing Address - Phone:619-670-6296
Mailing Address - Fax:619-670-8852
Practice Address - Street 1:2650 JAMACHA RD
Practice Address - Street 2:SUITE 155
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92019-4319
Practice Address - Country:US
Practice Address - Phone:619-670-6296
Practice Address - Fax:619-670-8852
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT9378TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0093780Medicaid
CASD0093780Medicaid
CAOP9378Medicare ID - Type Unspecified