Provider Demographics
NPI:1457559593
Name:MERCER, AMANDA MEREDITH HOBBS (OD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:MEREDITH HOBBS
Last Name:MERCER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AMANDA
Other - Middle Name:MEREDITH
Other - Last Name:HOBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1545 ADAMS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-3814
Mailing Address - Country:US
Mailing Address - Phone:714-545-9162
Mailing Address - Fax:714-241-1345
Practice Address - Street 1:1545 ADAMS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-3814
Practice Address - Country:US
Practice Address - Phone:714-545-9162
Practice Address - Fax:714-241-1345
Is Sole Proprietor?:No
Enumeration Date:2007-07-10
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13629152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist