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Individual

EMMY THAI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
15268 SUMMIT AVE STE 300, FONTANA, CA 92336-0234
(909) 279-2472
(909) 279-2479
Mailing address
4855 CONDOR AVE, FONTANA, CA 92336-4715
(714) 360-2858

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34754TLG
CA

Other

Enumeration date
02/09/2021
Last updated
02/23/2024
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