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General NPI Number Information
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NPI Number | 1326246174
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Entity Type | Organization
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Legal Business Name | IRENE YIM OPTOMETRIC CORP.
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Dates
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Enumeration Date | 07/03/2007
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 18337 COLIMA RD
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-2762
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Country | US
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Telephone | 626-854-1131
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Fax | 626-854-1727
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Provider Business Mailing Address
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Address Line | 18337 COLIMA RD
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City | ROWLAND HEIGHTS
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State | CA
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Zip | 91748-2762
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Country | US
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Telephone | 626-854-1131
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Fax | 626-854-1727
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Authorized Official
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Title or Position | PRESIDENT
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Name | IRENE INKYUNG YIM
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Credential | O.D.
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Telephone | 626-854-1131
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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 | 9722
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License Number State | CA
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