Doctor Name: | DR. CHRISTOPHER MEDINA |
NPI Number: | 1669832846 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | O.D. |
License Number: | OL-029 |
Business Practice Address: | Concourse 4 Micronesia Mall Ideal Optical Dededo, GU - 96929 |
Business Phone Number: | 6716378141 |
Business Fax Number: | |
Mailing Address: | Po Box 24724, BARRIGADA |
State: | GU |
Postal Code: | 969214724 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 03/01/2016 |
NPI Last Update Date: | 03/01/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 152WC0802X |
License Number: | OL-029 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GU |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Optometrist |
Taxonomy Specialization: | Corneal and Contact Management |
Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |