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Individual

MAGGIE JAN

Active
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Individual

MAGGIE JAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14641TLG
CA
152WC0802X
Corneal and Contact Management Optometrist
14641TLG
CA
152WL0500X
Low Vision Rehabilitation Optometrist
14641TLG
CA
152WX0102X
Occupational Vision Optometrist
14641TLG
CA

Other

Enumeration date
01/21/2014
Last updated
05/06/2026
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