Hustana, Lara Dawn
Hustana, Lara Dawn is an individual health care provider with primary practice located at 9415 Campus Point Dr , La Jolla CA 92037-1350. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Hustana, Lara Dawn can be contacted via phone (858) 534-6291.Contact Information
Primary practice address
9415 Campus Point Dr
La Jolla CA 92037-1350
Phone: (858) 534-6291
Fax: (858) 822-4438
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT11472T | California |
Profile Details
| NPI number | 1235161597 |
|---|---|
| LBN Legal business name | Hustana, Lara Dawn |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 7th, 2006 |
| Last updated | Jan 29th, 2024 - about 10 months 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 | 1235161597 | NPPES |
| California | MEDICAID | SDO114720 |
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