| NPI | 1306301304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADINE GONZALEZ Credentialing Coordinator 626-269-5371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2019-02-04 |
| Last Update Date | 2019-08-13 |