| NPI | 1710229604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONY PARK Owner 510-366-3506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NY TUV 007776) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2018-04-02 |