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Individual

DR. JEAN MARIE WANG MENGOLI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
4405 VANDEVER AVE, SAN DIEGO, CA 92120-3315
(503) 936-4136
Mailing address
4405 VANDEVER AVE, SAN DIEGO, CA 92120-3315
(503) 936-4136

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11975T
CA

Other

Enumeration date
02/01/2007
Last updated
12/22/2021
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