| NPI | 1396259669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER KHEM CEO 424-346-2845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 15317TLG) |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 15317TLG) |
| 152WP0200X Optometrist, Pediatrics (Licence: CA 15317TLG) | |
| Enumeration Date | 2017-11-25 |
| Last Update Date | 2019-07-15 |