| NPI | 1619337110 |
|---|---|
| Former Legal Business Name | FOLSOM LAKE EYE CARE OPTOMETRIC |
| Entity Type | Organization |
| Authorized Contact | NIAM PHAN President 209-380-8145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14181 TLG) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2022-07-21 |