Organization
GORDON K. OTA, O.D. A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON K OTA O.D. (PRESIDENT)
(714) 965-5130
Entity
Organization
Contact information
Practice address
10130 WARNER AVE, SUITE J, FOUNTAIN VALLEY, CA 92708-1619
(714) 965-5130
(714) 965-8265
Mailing address
10130 WARNER AVE, SUITE J, FOUNTAIN VALLEY, CA 92708-1619
(714) 965-5130
(714) 965-8265
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7549T
CA
Other
Enumeration date
04/06/2007
Last updated
09/04/2012
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