Super, Paul Jonathan

Super, Paul Jonathan is an individual health care provider with primary practice located at 11696 San Vicente Blvd , Los Angeles CA 90049-5104. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Corneal and Contact Management, Eye and Vision Services Providers / Optometrist. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Super, Paul Jonathan can be contacted via phone (310) 820-2020.

Contact Information

Primary practice address
11696 San Vicente Blvd Los Angeles CA 90049-5104
Phone: (310) 820-2020
Fax: (310) 820-1884
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X OP8867TPG California
Eye and Vision Services Providers / Optometrist 152W00000X OPT8867 California

Profile Details

NPI number 1649499807
LBN Legal business name Super, Paul Jonathan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2007
Last updated Dec 23rd, 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.

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