Beverly Grove Vision Care Optometry, INC
NPI #1003325390 in Los Angeles, California
Provider Information
- NPI Number
- 1003325390
- Entity Type
- Organization
- Organization Name
- Beverly Grove Vision Care Optometry, INC
- Primary Specialty
- Optometrist
- Enumeration Date
- Sep 29, 2017
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 511 S FAIRFAX AVE
- City
- Los Angeles
- State
- California
- ZIP Code
- 90036-3130
- Phone
- (323) 879-9259
Authorized Official
- Name
- DR. DANIELLE TAMMY ROTH, OD
- Title
- DOCTOR
- Phone
- (323) 879-9259
Specialties & Taxonomy Codes
| Specialty |
|---|
| Optometrist |
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