Vidal, J Michael
Vidal, J Michael is an sole proprietor health care provider with primary practice located at 7090 Parkway Dr , La Mesa CA 91942-1596. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Vidal, J Michael can be contacted via phone (619) 460-2020.Contact Information
Primary practice address
7090 Parkway Dr
La Mesa CA 91942-1596
Phone: (619) 460-2020
Fax: (619) 462-2020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | CA61320 | California |
Profile Details
| NPI number | 1457311128 |
|---|---|
| LBN Legal business name | Vidal, J Michael |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 25th, 2006 |
| Last updated | Feb 11th, 2014 - about 10 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 | 1457311128 | NPPES |
| California | MEDICAID | SD0061320 |
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