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General NPI Number Information
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NPI Number | 1871304089
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Entity Type | Organization
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Legal Business Name | LAUREN M. SOOHOO OPTOMETRIC CORP.
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 4651 FIRESTONE BLVD
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City | SOUTH GATE
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State | CA
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Zip | 90280-3446
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Country | US
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Telephone | 714-452-7807
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Fax |
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Provider Business Mailing Address
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Address Line | 808 WESTMORELAND DR
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City | MONTEBELLO
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State | CA
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Zip | 90640-2452
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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 | LAUREN MONSANTO SOOHOO
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Credential | OD
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Telephone | 714-452-7807
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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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