Individual
BRIAN EDWARD WONG PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1695 ARDEN WAY, SACRAMENTO, CA 95815-4004
(916) 564-5983
Mailing address
7116 SHERICE CT, SACRAMENTO, CA 95831-3041
(916) 607-2833
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
15075
CA
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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