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General NPI Number Information
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NPI Number | 1578619615
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Entity Type | Organization
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Legal Business Name | DAVID J LAU & WESLEY S UMEDA PTR
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 01/21/2015
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Provider Practice Location Address
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Address Line | 7547 SUNSET AVE
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City | FAIR OAKS
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State | CA
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Zip | 95628-4720
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Country | US
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Telephone | 916-965-1017
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Fax |
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Provider Business Mailing Address
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Address Line | 7547 SUNSET AVE
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City | FAIR OAKS
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State | CA
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Zip | 95628-4720
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Country | US
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Telephone | 916-965-1017
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. WESLEY S UMEDA
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Credential | O.D.
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Telephone | 916-965-1017
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 8039TPL
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License Number State | CA
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