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NPI Code Detail

MEDICARE: DOROTHY Z WANG OPTOMETRY INC

MEDICARE: DOROTHY Z WANG OPTOMETRY INC
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
1152W00000XOptometrist13420CA

General Provider Information

NPI Number : 1487084034
Entity Type Code : Organization
Provider Name (Legal Business Name) : DOROTHY Z WANG OPTOMETRY INC
Provider Business Mailing Address
First Line : 13350 CAMINO DEL SUR
Second Line : SUITE 8
City : SAN DIEGO
State : CA
Zip : 92129-4473
Country : US
Telephone Number : 858-324-0089
Fax Number : 858-324-0090
Provider Business Practice Location Address
First Line : 13350 CAMINO DEL SUR
Second Line : SUITE 8
City : SAN DIEGO
State : CA
Zip : 92129-4473
Country : US
Telephone Number : 858-324-0089
Fax Number : 858-324-0090
Authorized Official
Title or Position : PRESIDENT/CEO
Name : DR. DOROTHY ZHIJUAN WANG
Credential : O.D.
Telephone Number : 858-324-0089
Provider Enumeration Date : 11/19/2013
Last Update Date : 09/08/2014

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Directions to “DOROTHY Z WANG OPTOMETRY INC ” Practice Location

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