Individual
MR. KIP MCGOODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.D.O.
Contact information
Practice address
783 RIO DEL MAR BLVD STE 37, APTOS, CA 95003-4700
(831) 688-1516
Mailing address
783 RIO DEL MAR BLVD, STE 37, APTOS, CA 95003-4771
(831) 688-1516
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
2717
CA
Other
Enumeration date
12/15/2006
Last updated
08/08/2008
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