Organization
CHRIS IWATA, OD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULINE KITAGAWA (MANAGER)
(209) 736-0908
Entity
Organization
Contact information
Practice address
595 STANISLAUS AVE STE C, ANGELS CAMP, CA 95222-9356
(209) 736-0908
Mailing address
595 STANISLAUS AVE STE C, ANGELS CAMP, CA 95222-9356
(209) 736-0908
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5700TLG
CA
Other
Enumeration date
08/09/2016
Last updated
08/09/2016
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