Organization
FAMILY VISION CARE OPTOMETRY OF MODESTO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELDON LANG ROSENOW OD (PRESIDENT)
(209) 524-9291
Entity
Organization
Contact information
Practice address
817 COFFEE RD, BUILDING D, MODESTO, CA 95355-4241
(209) 524-9291
(209) 524-6362
Mailing address
817 COFFEE RD, BUILDING D, MODESTO, CA 95355-4241
(209) 524-9291
(209) 524-6362
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4827220001
DMERC
CA
Enumeration date
02/28/2007
Last updated
08/22/2020
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