Individual
JASON MATTHEW THAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1515 N VERMONT AVE FL 6, LOS ANGELES, CA 90027-5337
(323) 783-4118
Mailing address
1515 N VERMONT AVE FL 6, LOS ANGELES, CA 90027-5337
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT36004-TLG
CA
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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