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General NPI Number Information
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NPI Number | 1437697232
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Entity Type | Organization
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Legal Business Name | WOO OPTOMETRY, INC.
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Dates
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Enumeration Date | 02/01/2017
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | 10075 BRUCEVILLE RD
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City | ELK GROVE
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State | CA
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Zip | 95757-9501
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Country | US
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Telephone | 916-686-7051
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Fax |
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Provider Business Mailing Address
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Address Line | 5050 LAGUNA BLVD # 112312
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City | ELK GROVE
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State | CA
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Zip | 95758-4151
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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 | PRESIDENT
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Name | CYNTHIA WOO
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Credential | OD
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Telephone | 916-686-7051
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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 | 10666TPG
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License Number State | CA
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