Ventocilla, Mark Augusto
Ventocilla, Mark Augusto is an sole proprietor health care provider with primary practice located at 613 E Grand Ave , Escondido CA 92025-4402. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Ventocilla, Mark Augusto can be contacted via phone (760) 747-4797.Contact Information
Primary practice address
613 E Grand Ave
Escondido CA 92025-4402
Phone: (760) 747-4797
Fax: (760) 747-7799
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 4901003734 | Michigan |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPC 3532 | Florida |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 10435 | California |
Profile Details
| NPI number | 1528158664 |
|---|---|
| LBN Legal business name | Ventocilla, Mark Augusto |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 12th, 2006 |
| Last updated | Mar 12th, 2012 - about 14 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 | 1528158664 | NPPES |
| Michigan | MEDICAID | 4454950 | |
| Michigan | MEDICAID | 4820570 | |
| Michigan | Other | 900F165350 | |
| Michigan | Other | 90G011590 |
Popular Providers
-
Tornatore, Marty Caron
225 E 2Nd Ave Ste. 310, Escondido CA 92025-4212 -
Smith, Oliver Frank
201 W Valley Pkwy , Escondido CA 92025-2608 -
Will, Alan David
1264-A Auto Pkwy , Escondido CA 92029 -
Delgado, Daniel R
613 E Grand Ave , Escondido CA 92025-4402 -
Frimtzis, Bruce G.
1320 E Valley Pkwy Ste D , Escondido CA 92027-2317 -
Haug, Michael James
316 W Mission Ave Suite #118, Escondido CA 92025-1731 -
Shaw, Basanti
1835 S Centre City Parkway Suite #E, Escondido CA 92025-6544 -
Nguyen, Ngoc Mong Hoang
1264 Auto Pkwy Ste A, Escondido CA 92029