Individual
MR. JIMMY JIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.B.O.C.
Contact information
Practice address
18557 SHERMAN WAY, RESEDA, CA 91335-4144
(818) 344-3064
(818) 344-3065
Mailing address
18557 SHERMAN WAY, RESEDA, CA 91335-4144
(818) 344-3064
(818) 344-3065
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SL2290
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DX0066770
—
CA
Enumeration date
01/18/2007
Last updated
07/09/2007
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