Individual
JANE D. GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
2001 4TH AVE, SAN DIEGO, CA 92101-2303
(619) 466-1560
(619) 446-1692
Mailing address
2001 4TH AVE, SAN DIEGO, CA 92101-2303
(619) 466-1560
(619) 446-1692
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT6936T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0069360
—
CA
Enumeration date
08/19/2006
Last updated
06/19/2013
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