Organization
IMPERIAL VALLEY OPTOMETRIC CORPORATION
Active
Other names
Optom Eyes Vision Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAY C TAM O.D. (VICE PRESIDENT)
(760) 336-3003
Entity
Organization
Contact information
Practice address
5638 MISSION CENTER RD, STE 103, SAN DIEGO, CA 92108-4348
(619) 295-2900
(888) 210-5799
Mailing address
3451 S DOGWOOD AVE, STE 1334, EL CENTRO, CA 92243
(760) 336-3003
(888) 210-5799
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD005600
—
CA
Enumeration date
12/01/2011
Last updated
12/06/2011
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