Individual
DR. BRYAN TAKANORI IMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BRYAN IMOTO O.D.
Contact information
Practice address
11436 ARTESIA BLVD, SUITE D, ARTESIA, CA 90701-3859
(562) 860-1717
Mailing address
11436 ARTESIA BLVD, SUITE D, ARTESIA, CA 90701-3859
(562) 860-1717
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14401
CA
Other
Enumeration date
06/18/2012
Last updated
06/18/2012
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