| NPI | 1760671267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY WANG Owner 909-982-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 11233T) |
| Additional Taxonomies | 332H00000X Eyewear Supplier (Equipment, not the service) (Licence: CA 11233T) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2008-02-29 |