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Individual

ELAINE SEONOG KWON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
2380 IRVING ST, SAN FRANCISCO, CA 94122-1621
(415) 566-8199
(415) 566-8198
Mailing address
2380 IRVING ST, SAN FRANCISCO, CA 94122-1621
(415) 566-8199
(415) 566-8198

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
11788T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
16524
MES
CA
01
72-1584284
FEIN
CA
Enumeration date
03/17/2007
Last updated
02/18/2014
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