| NPI | 1861189011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIMIA WEN President/Authorized Official 949-432-7894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| Enumeration Date | 2023-04-19 |
| Last Update Date | 2023-07-19 |