Brunette, Mark
Brunette, Mark is an individual health care provider with primary practice located at 3085 Loma Vista Rd , Ventura CA 93003-2916. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Brunette, Mark can be contacted via phone (805) 648-3085.Contact Information
Primary practice address
3085 Loma Vista Rd
Ventura CA 93003-2916
Phone: (805) 648-3085
Fax: (805) 648-7027
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT8935 | California |
Profile Details
| NPI number | 1538105846 |
|---|---|
| LBN Legal business name | Brunette, Mark |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 22nd, 2006 |
| Last updated | Dec 8th, 2020 - about 4 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 | 1538105846 | NPPES |
| California | Other | 8935T | CHAMPUS |
| California | Other | 205153800 | CHAMPUS |
| California | Other | WOP8935B | CHAMPUS |
| California | Other | 8935T | CHAMPUS |
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