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Organization
JON G. WADA, O.D.
Active
Organization
JON G. WADA, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON GORDON WADA O.D. (OWNER)
(408) 243-7916
Entity
Organization
Contact information
Practice address
2405 FOREST AVE, SAN JOSE, CA 95128-1500
(408) 243-7916
(408) 243-3525
Mailing address
2405 FOREST AVE, SAN JOSE, CA 95128-1500
(408) 243-7916
(408) 243-3525
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9115
CA
152WC0802X
Corneal and Contact Management Optometrist
9115
CA
152WL0500X
Low Vision Rehabilitation Optometrist
9115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0091150
—
CA
Enumeration date
12/13/2006
Last updated
05/15/2015
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