Healthcare Provider Details

I. General information

NPI: 1992003990
Provider Name (Legal Business Name): GOLDEN, ARDAYA & LIN OPTOMETRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2011
Last Update Date: 01/18/2012
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 Number12724
License Number StateCA

VIII. Authorized Official

Name: DR. DAVID C. ARDAYA
Title or Position: OPTOMETRIST/PARTNER
Credential: O.D.
Phone: 562-692-1208