Demoss, Mary Lucinda
Demoss, Mary Lucinda is an individual health care provider with primary practice located at 31722 Railroad Canyon Rd , Canyon Lake CA 92587-9486. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Demoss, Mary Lucinda can be contacted via phone (951) 244-4444.Contact Information
Primary practice address
31722 Railroad Canyon Rd
Canyon Lake CA 92587-9486
Phone: (951) 244-4444
Fax: (951) 244-1414
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 8955 | California |
Profile Details
| NPI number | 1912958539 |
|---|---|
| LBN Legal business name | Demoss, Mary Lucinda |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 16th, 2006 |
| Last updated | Nov 4th, 2016 - about 9 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 | 1912958539 | NPPES |
| California | MEDICAID | SD0089550 |
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