| NPI | 1134491012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA D FORESTER Account Manager 510-489-5510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT 6732 TPA) |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-02-07 |