Provider Demographics
NPI:1992856231
Name:CHRISTOPHER J. ORENIC, O.D. INC
Entity Type:Organization
Organization Name:CHRISTOPHER J. ORENIC, O.D. INC
Other - Org Name:ADVANCED EYECARE CENTER OF MANHATTAN BEACH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ORENIC
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-321-6990
Mailing Address - Street 1:2101 ROSECRANS AVE STE 1215
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-4749
Mailing Address - Country:US
Mailing Address - Phone:310-210-6990
Mailing Address - Fax:310-321-6170
Practice Address - Street 1:2101 ROSECRANS AVE STE 1215
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-4749
Practice Address - Country:US
Practice Address - Phone:310-210-6990
Practice Address - Fax:310-321-6170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 10056 TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U61098Medicare UPIN