Organization
ARTESIA I CARE OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEN IMOTO O.D. (OWNER/OPTOMETRIST)
(562) 860-1717
Entity
Organization
Contact information
Practice address
11436 ARTESIA BLVD STE D, ARTESIA, CA 90701-3859
(562) 860-1717
Mailing address
11436 ARTESIA BLVD STE D, ARTESIA, CA 90701-3859
(562) 860-1717
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5286 T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0052860
—
CA
Enumeration date
01/14/2015
Last updated
01/14/2015
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