Healthcare Provider Details

I. General information

NPI: 1962764340
Provider Name (Legal Business Name): GOLDEN ARDAYA & LIN OPTOMETRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2012
Last Update Date: 07/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11245 WASHINGTON BLVD
WHITTIER CA
90606-3111
US

IV. Provider business mailing address

11245 WASHINGTON BLVD
WHITTIER CA
90606-3111
US

V. Phone/Fax

Practice location:
  • Phone: 562-692-1208
  • Fax: 562-695-6386
Mailing address:
  • Phone: 562-692-1208
  • Fax: 562-695-6386

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DAVID B GOLDEN
Title or Position: OWNER/PARTNER
Credential:
Phone: 562-692-1208