Organization
ALICE PANG, O.D., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALICE PANG OD (CEO/OPTOMETRIST)
(562) 602-0368
Entity
Organization
Contact information
Practice address
141 LAKEWOOD CENTER MALL, LAKEWOOD, CA 90712-2419
(562) 602-0368
(888) 965-0574
Mailing address
12642 OHMER WAY, GARDEN GROVE, CA 92841-4826
(562) 602-0368
(888) 965-0574
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629233754
NPI
CA
Enumeration date
04/30/2019
Last updated
08/03/2022
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