| NPI | 1689354557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS FONG President 916-451-4494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 152WC0802X Optometrist, Corneal and Contact Management |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-07-24 |