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General NPI Number Information
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NPI Number | 1518724186
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Entity Type | Organization
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Legal Business Name | SLN VISIONARY GROUP
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Dates
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Enumeration Date | 02/29/2024
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 1900 PRAIRIE CITY RD # FM7
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City | FOLSOM
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State | CA
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Zip | 95630-9501
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Country | US
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Telephone | 916-377-9909
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Fax |
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Provider Business Mailing Address
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Address Line | 1930 9TH ST STE 212
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City | SACRAMENTO
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State | CA
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Zip | 95811-7076
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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 | CEO
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Name | LINH NGO
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Credential | OD
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Telephone | 916-803-9103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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