Organization
GRACE J. DACANAY O.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRACE DACANAY O.D. (OWNER)
(626) 961-0876
Entity
Organization
Contact information
Practice address
15909 MAIN ST, LA PUENTE, CA 91744-4720
(626) 961-0876
Mailing address
15909 MAIN ST, LA PUENTE, CA 91744-4720
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
12589T
CA
Other
Enumeration date
11/24/2014
Last updated
11/25/2014
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