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Organization

GOLDEN SAN GABRIEL OPTOMETRIC VISION CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JIYEN SHIN O.D. (OWNER/OPTOMETRIS)
(626) 288-8023
Entity
Organization

Contact information

Practice address
140 W VALLEY BLVD, #115, SAN GABRIEL, CA 91776-3760
(626) 288-8023
(626) 288-8326
Mailing address
140 W VALLEY BLVD, #115, SAN GABRIEL, CA 91776-3760
(626) 288-8023
(626) 288-8326

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9727
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GSD001490
CA
Enumeration date
06/23/2006
Last updated
03/27/2014
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