| NPI | 1558510834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD CHUNG Administrator 818-275-0009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA W20551) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CA G044103) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2023-08-22 |