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Organization
VANHOOSE & KIMBALL OPTOMETRIC CORP
Active
Organization
VANHOOSE & KIMBALL OPTOMETRIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE W KIMBALL O.D. (OFFICER OF CORP)
(858) 453-4112
Entity
Organization
Contact information
Practice address
4575 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92122-1203
(858) 453-4112
(858) 453-4398
Mailing address
4575 LA JOLLA VILLAGE DR, SAN DIEGO, CA 92122
(858) 453-4112
(858) 453-4398
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6064-T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0060642
—
CA
Enumeration date
12/19/2007
Last updated
09/24/2012
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