| NPI | 1720591480 |
|---|---|
| Doing Business As | STATE STREET OPTOMETRY |
| Entity Type | Organization |
| Authorized Contact | JEFFRY WU President 909-792-2280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 15020) |
| Additional Taxonomies | 152WX0102X Optometrist, Occupational Vision (Licence: CA 15020) |
| 152WC0802X Optometrist, Corneal and Contact Management (Licence: CA 15020) | |
| 152WP0200X Optometrist, Pediatrics (Licence: CA 15020) | |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2020-07-20 |