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Contact Information

BRIAN E VANDUSEN, OD
3559 W RAMSEY ST
STE D-6
BANNING, CA92220
 Phone: 951-849-2020
 Fax: 951-849-4869
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for BRIAN E VANDUSEN · (Male)

NPI Number 1437338407
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 10/26/2007
Last updated 05/15/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 007596T
  • CA Medicaid SD0075960
  • CA Medicaid SD0075961
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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