NPI 1003849712

Pauline F Ilsen, OD

Practitioner Optometrist Los Angeles, CA

Practice location

Address: 11301 Wilshire Blvd West La Veterans Affairs Healthcare Ctr B 304 Rm 2-111, Los Angeles, CA 90073-1003
Phone: (310) 478-3711
Fax: (310) 268-3780

Registered specialties (5)

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 8974T (CA)

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Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence 1513 (CO)

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2001T (OR)

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2211 (TN)

Optometrist

Eye and Vision Services Providers Taxonomy 152W00000X Licence 2068 (WA)

Registry record

NPI: 1003849712
Entity type: Individual
Sex (as registered): Female
NPI issued: 8 Jul 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.