Provider Demographics
NPI:1316493158
Name:FUENTES, ALMA LEONELI (OD)
Entity type:Individual
Prefix:DR
First Name:ALMA
Middle Name:LEONELI
Last Name:FUENTES
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 LONG BEACH BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-2615
Mailing Address - Country:US
Mailing Address - Phone:562-685-8605
Mailing Address - Fax:
Practice Address - Street 1:3900 LONG BEACH BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2615
Practice Address - Country:US
Practice Address - Phone:562-685-8605
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60685047152W00000X
CAOPT36109-TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist