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General NPI Number Information
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NPI Number | 1174176820
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Entity Type | Organization
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Legal Business Name | GOLDEN IRVINE OPTOMETRY INC.
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Dates
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Enumeration Date | 07/22/2019
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 15435 JEFFREY RD STE 138
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City | IRVINE
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State | CA
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Zip | 92618-4112
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Country | US
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Telephone | 949-577-8844
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Fax |
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Provider Business Mailing Address
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Address Line | 15435 JEFFREY RD STE 138
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City | IRVINE
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State | CA
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Zip | 92618-4112
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | O.D.
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Name | DENNIS LEUNG
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Credential |
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Telephone | 495-778-8449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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