Provider Demographics
NPI:1861621484
Name:HORVATH & CHRISTENSEN OD PROF
Entity type:Organization
Organization Name:HORVATH & CHRISTENSEN OD PROF
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/VP
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:CHRISTENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-837-2121
Mailing Address - Street 1:22681 LAKE FOREST DR STE A2
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-1799
Mailing Address - Country:US
Mailing Address - Phone:949-837-2121
Mailing Address - Fax:949-837-6215
Practice Address - Street 1:22681 LAKE FOREST DR STE A2
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-1799
Practice Address - Country:US
Practice Address - Phone:949-837-2121
Practice Address - Fax:949-837-6215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-02
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8694T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty