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Organization
TERUO WATANABE, O.D., INC.
Active
Organization
TERUO WATANABE, O.D., INC.
Active
Other names
PLAZAVISION OPTOMETRY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERUO WATANABE O.D. (OPTOMETRIST/PRESIDENT)
(626) 912-3937
Entity
Organization
Contact information
Practice address
18045 GALE AVE, CITY OF INDUSTRY, CA 91748-1245
(626) 912-3937
(626) 913-8869
Mailing address
18045 GALE AVE, CITY OF INDUSTRY, CA 91748-1245
(626) 912-3937
(626) 913-8869
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5612T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FV512A
GROUP
CA
05
—
SD0056121
—
CA
Enumeration date
09/29/2006
Last updated
06/14/2012
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