Canyon Lake Vision Center

LBN: Mary L. Demoss O.D. Inc.
Canyon Lake Vision Center is an health care organization with primary practice located at 31722 Railroad Canyon Rd , Canyon Lake CA 92587-9486. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Mary L. Demoss O.D. Inc. can be contacted via phone (951) 244-4444, or through Demoss, Mary Lucinda 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:
Map and Directions
Authorized official contact:
Name: Demoss, Mary Lucinda Doctor of Optometry (OD)
Phone: (951) 244-4444

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 8955 California

Profile Details

NPI number 1457396871
LBN Legal business name Mary L. Demoss O.D. Inc.
DBA Doing business as Canyon Lake Vision Center
Authorized official Demoss, Mary Lucinda Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 19th, 2006
Last updated Feb 13th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457396871 NPPES
California MEDICAID GSD004910

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