| NPI | 1811023724 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CALLAWAY Insurance Supervisor 530-222-3166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 6443T) |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2019-09-17 |