Provider Demographics
NPI:1932246279
Name:RICHARD L. FORGEY LORI L. MATSUNO PARTNERSHIP
Entity Type:Organization
Organization Name:RICHARD L. FORGEY LORI L. MATSUNO PARTNERSHIP
Other - Org Name:DRS. FORGEY & MATSUNO
Other - Org Type:Other Name
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LORI
Authorized Official - Middle Name:L
Authorized Official - Last Name:MATSUNO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-857-0234
Mailing Address - Street 1:210 S GRAND AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91741-4263
Mailing Address - Country:US
Mailing Address - Phone:626-857-0234
Mailing Address - Fax:626-857-0857
Practice Address - Street 1:210 S GRAND AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91741-4263
Practice Address - Country:US
Practice Address - Phone:626-857-0234
Practice Address - Fax:626-857-0857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1247510001Medicare NSC
CA4901030002Medicare NSC