Individual
DR. SHANIDA PATSAMARN INGALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
3801 MIRANDA AVE, OPTOMETRY #112, PALO ALTO, CA 94304-1207
(650) 493-5000
Mailing address
32803 LAKE MEAD DR, FREMONT, CA 94555-1227
(510) 441-1470
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
12182T
CA
Other
Enumeration date
08/10/2006
Last updated
07/08/2007
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