Booth, Lowell John
Booth, Lowell John is an sole proprietor health care provider with primary practice located at 1102 Irvine Blvd , Tustin CA 92780-3529. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Booth, Lowell John can be contacted via phone (714) 838-3210.Contact Information
Primary practice address
1102 Irvine Blvd
Tustin CA 92780-3529
Phone: (714) 838-3210
Fax: (714) 838-5702
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT4984 TPL | California |
Profile Details
| NPI number | 1750361424 |
|---|---|
| LBN Legal business name | Booth, Lowell John |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 19th, 2006 |
| Last updated | Jan 23rd, 2009 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750361424 | NPPES |
| California | Other | 4984T | VBA |
| California | MEDICAID | SD0049840 | VBA |
| California | Other | 3108 | VBA |
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