Provider Demographics
NPI:1982886735
Name:TERI L. ALPERT, O.D.
Entity Type:Organization
Organization Name:TERI L. ALPERT, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:ALPERT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-364-0891
Mailing Address - Street 1:28601 MARGUERITE PKWY
Mailing Address - Street 2:SUITE #3
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92692-3726
Mailing Address - Country:US
Mailing Address - Phone:949-364-0891
Mailing Address - Fax:949-666-5149
Practice Address - Street 1:28601 MARGUERITE PKWY
Practice Address - Street 2:SUITE #3
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-3726
Practice Address - Country:US
Practice Address - Phone:949-364-0891
Practice Address - Fax:949-666-5149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-04
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA71160152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0217340001Medicare NSC
OP7116Medicare PIN
CAT70175Medicare UPIN