Provider Demographics
NPI:1194998906
Name:OMBRES, PAMELA VINES (MD)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:VINES
Last Name:OMBRES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 CAMINITO BRISA
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-5704
Mailing Address - Country:US
Mailing Address - Phone:858-459-0213
Mailing Address - Fax:
Practice Address - Street 1:1869 CAMINITO BRISA
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-5704
Practice Address - Country:US
Practice Address - Phone:858-459-0213
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-12
Last Update Date:2008-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA26788207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology