Individual
AMY TO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
477 E COLORADO BLVD, PASADENA, CA 91101-2024
(626) 796-1191
(626) 796-0189
Mailing address
11938 ROSEGLEN ST, EL MONTE, CA 91732-1632
(626) 348-1761
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
33852TLG
CA
Other
Enumeration date
10/18/2017
Last updated
06/15/2024
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