Wells, Mary Melinda

Wells, Mary Melinda is an sole proprietor health care provider with primary practice located at 23591 El Toro Road Ste 145, Lake Forest CA 92630. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Wells, Mary Melinda can be contacted via phone (949) 859-3180.

Contact Information

Primary practice address
23591 El Toro Road Ste 145 Lake Forest CA 92630
Phone: (949) 859-3180
Fax: (949) 859-6317
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 0P9120T California

Profile Details

NPI number 1093851610
LBN Legal business name Wells, Mary Melinda
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 30th, 2007
Last updated Mar 13th, 2009 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1093851610 NPPES
California MEDICAID 8566227

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