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Organization
PACIFIC VISION CARE, OPTOMETRIC SERVICES, INC.
Active
Organization
PACIFIC VISION CARE, OPTOMETRIC SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DERRICK EN-PEI WOO O.D. (PRESIDENT/OPTOMETRIST)
(562) 867-2020
Entity
Organization
Contact information
Practice address
5532 WOODRUFF AVE, LAKEWOOD, CA 90713-1535
(562) 867-2020
(562) 867-6100
Mailing address
5532 WOODRUFF AVE, LAKEWOOD, CA 90713-1535
(562) 867-2020
(562) 867-6100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11781TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02-6308745
VSP
CA
01
—
11781TLG
STATE LICENSE
CA
01
—
11934066
CAQH
CA
05
—
SD0117810
—
CA
Enumeration date
11/15/2014
Last updated
11/15/2014
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