Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MISS TIERRA ILICIA LEIGH GRUBBS, ABOC, FNAO
Active Sole ProprietorMISS TIERRA ILICIA LEIGH GRUBBS, ABOC, FNAO is a Optician, Dispensing healthcare provider located in COSTA MESA, California. NPI 1164889424 is currently active in the NPPES registry. Verify at CMS.
Optician, Dispensing · COSTA MESA, CA
Registration Details
- NPI Number
- 1164889424
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 18, 2016 (10.600870658904 yrs)
- Last Updated
- Jan 18, 2016
- Licenses
-
D70604 (CA)SL40306 (CA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
575 ANTON BLVD FL 3COSTA MESA, CA, 926267169Browse CA providers · Browse ZIP 92626
- Phone
- 5623135202
- Primary Specialty
-
Optician, Dispensing
156FX1800X
- Additional Specialty
- Optician, Dispensing
Other Optician, Dispensing Providers in COSTA MESA, CA
| Name | Credential | NPI |
|---|---|---|
| MINSOO KIM | — | 1174297360 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.