Vacharkulksemsuk, Tara
Vacharkulksemsuk, Tara is an individual health care provider with primary practice located at 32245 Mission Trl Ste D4 , Lake Elsinore CA 92530-4528. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Vacharkulksemsuk, Tara can be contacted via phone (951) 674-1561.Contact Information
Primary practice address
32245 Mission Trl Ste D4
Lake Elsinore CA 92530-4528
Phone: (951) 674-1561
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 13949 | California |
Profile Details
| NPI number | 1588977938 |
|---|---|
| LBN Legal business name | Vacharkulksemsuk, Tara |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2010 |
| Last updated | Nov 30th, 2021 - 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 | 1588977938 | NPPES |
| Texas | MEDICAID | 112409104 | |
| Texas | MEDICAID | 283028301 |
Popular Providers
-
Homuth, Robert Morgan
29315 Central Ave , Lake Elsinore CA 92532-2212 -
Michaels, Justin B
23002 Lake Center Dr , Lake Forest CA 92630-6801 -
Schroeder, Stephen Gerard
25321 Railroad Canyon Dr. #503, Lake Elsinore CA 92532 -
Deguzman Celis, John
23600 Rockfield Blvd Suite 3F, Lake Forest CA 92630-1624 -
Khodai, Omid
23 Bellflower , Lake Forest CA 92630-8377 -
Demoss, Mary Lucinda
31722 Railroad Canyon Rd , Canyon Lake CA 92587-9486 -
Cullinane, Jacqueline Marie
22741 Lambert St Ste 1601 , Lake Forest CA 92630-1617 -
Cruz, Michelle
32245 Mission Trl Ste D4 , Lake Elsinore CA 92530-4528