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Organization
PINHKEO SOUTHAPHANH O D INC
Active
Organization
PINHKEO SOUTHAPHANH O D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PINHKEO SOUTHAPHANH O.D. (PRESIDENT)
(805) 819-0742
Entity
Organization
Contact information
Practice address
415 E OCEAN AVE STE B, LOMPOC, CA 93436-6839
(805) 819-0742
(805) 741-7367
Mailing address
415 E OCEAN AVE STE B, LOMPOC, CA 93436-6839
(805) 819-0742
(805) 741-7367
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12359TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538139381
—
CA
Enumeration date
08/17/2016
Last updated
07/22/2024
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