MEDICARE: DOWNTOWN OPTOMETRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	11286	CA

General Provider Information

NPI Number	:	1063833234
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOWNTOWN OPTOMETRY

Provider Business Mailing Address
First Line	:	330 K ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-6959
Country	:	US
Telephone Number	:	619-231-5799
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 K ST
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92101-6959
Country	:	US
Telephone Number	:	619-231-5799
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. JASON TU
Credential	:	O.D.
Telephone Number	:	619-231-5799

Provider Enumeration Date	:	12/13/2013
Last Update Date	:	12/13/2013

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Directions to “DOWNTOWN OPTOMETRY ” Practice Location

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