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Organization
OPTOMETRIC GROUP
Active
Organization
OPTOMETRIC GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA HUANG OD (OWNER)
(510) 493-3357
Entity
Organization
Contact information
Practice address
46871 WARM SPRINGS BLVD, FREMONT, CA 94539-7922
(510) 493-3357
Mailing address
138 N MILPITAS BLVD, MILPITAS, CA 95035-4401
(510) 493-3357
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD123030
—
CA
Enumeration date
06/13/2019
Last updated
06/13/2019
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