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Organization

ELK GROVE OPTOMETRY A PROFESSIONAL CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DAVID T KAGEYAMA OD (PRESIDENT)
(916) 686-4937
Entity
Organization

Contact information

Practice address
9401 E STOCKTON BLVD, STE 105, ELK GROVE, CA 95624
(916) 686-4937
(916) 686-4469
Mailing address
9401 E STOCKTON BLVD, STE 105, ELK GROVE, CA 95624
(916) 686-4937
(916) 686-4469

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GDS00190
CA
Enumeration date
05/06/2006
Last updated
10/29/2013
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