Individual
JEANNIE WONG LIN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
491 30 ST, STE 101, OAKLAND, CA 94609
(516) 444-0603
(510) 872-3119
Mailing address
491 30 ST, STE 101, OAKLAND, CA 94609
(516) 444-0603
(510) 872-3119
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT11238
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
S70112780
—
CA
Enumeration date
02/13/2006
Last updated
07/08/2007
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