Individual
DONG EOK SHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4250 VAN BUREN BLVD, RIVERSIDE, CA 92503-2602
(909) 964-9524
Mailing address
23684 GOLD NUGGET AVE, DIAMOND BAR, CA 91765-2335
(213) 500-8292
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
70820
CA
Other
Enumeration date
07/18/2019
Last updated
01/23/2023
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