Individual
EMILY K SO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
17833 COLIMA RD, ROWLAND HEIGHTS, CA 91748-1729
(626) 964-7764
(626) 913-2910
Mailing address
301 W. HUNTINGTON DR., SUITE #107, ARCADIA, CA 91007-3400
(626) 574-0022
(626) 574-0040
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TLG13859
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EN061H
MEDICARE PTAN
CA
Enumeration date
05/05/2010
Last updated
03/12/2012
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