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Organization
WAN AND MASHOUF OPTOMETRIC CORP PC
Active
Organization
WAN AND MASHOUF OPTOMETRIC CORP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH MICHAEL WAN OD (OD/OWNER)
(858) 530-2800
Entity
Organization
Contact information
Practice address
10549 SCRIPPS POWAY PKWY, STE G, SAN DIEGO, CA 92131-3963
(858) 530-2800
(858) 530-2889
Mailing address
10549 SCRIPPS POWAY PKWY, STE G, SAN DIEGO, CA 92131-3963
(858) 530-2800
(858) 530-2889
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10924T
CA
Other
Enumeration date
05/27/2006
Last updated
02/04/2021
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