Organization
ICON OPTICAL INC
Active
Organization
ICON OPTICAL INC
Active
Other names
1001 OPTICAL
Organization subpart
No
Provider details
NPI number
Authorized official
BYUNGSOO CHAE (OWNER)
(213) 385-3388
Entity
Organization
Contact information
Practice address
2880 W OLYMPIC BLVD STE 101, LOS ANGELES, CA 90006-2644
(213) 385-3388
(213) 385-3328
Mailing address
2880 W OLYMPIC BLVD STE 101, LOS ANGELES, CA 90006-2644
(213) 385-3388
(213) 385-3328
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
27748407
CA
Other
Enumeration date
05/24/2013
Last updated
05/24/2013
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