Individual
ANDREW HIROSHI KAGEYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
9401 E STOCKTON BLVD STE 105, ELK GROVE, CA 95624-5050
(916) 686-4937
Mailing address
9401 E STOCKTON BLVD STE 105, ELK GROVE, CA 95624-5050
(916) 686-4937
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG003929
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OEG003929
LICENSE
PA
Enumeration date
07/05/2022
Last updated
03/03/2024
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