Individual
CONNIE TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
477 N EL CAMINO REAL STE C202, ENCINITAS, CA 92024-1332
(760) 631-3500
Mailing address
7637 HEATHERLY LN, SAN DIEGO, CA 92130-5602
(909) 569-3780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
08446
NY
152W00000X
Optometrist
Primary
33425
CA
Other
Enumeration date
06/24/2016
Last updated
07/15/2020
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