Organization
OPTIMUM IOM PRO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VILMA AZUCENA WHEELER (PARTNER)
(951) 897-0770
Entity
Organization
Contact information
Practice address
22841 COLORADO DR, PORTER, TX 77365-3635
(281) 772-9023
Mailing address
24046 CLINTON KEITH RD STE 101, WILDOMAR, CA 92595-8060
(281) 772-9023
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
Primary
—
—
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
03/10/2020
Last updated
02/17/2026
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