Individual
DR. CHRIS H. IWATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
595 STANISLAUS ST, STE C, ANGELS CAMP, CA 95222
(209) 736-0908
(209) 736-9352
Mailing address
PO BOX 501, ANGELS CAMP, CA 95222-0501
(209) 736-0908
(209) 736-9352
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5700T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
942507411
FEDERAL TAX ID
CA
Enumeration date
01/19/2006
Last updated
08/19/2008
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