| Woodbury Family Optometry | |
|
6270 Irvine Blvd Irvine CA 92620-2103 | |
| (949) 786-0143 | |
| (949) 786-0492 |
| Full Name | Woodbury Family Optometry |
|---|---|
| Speciality | Clinic/center |
| Location | 6270 Irvine Blvd, Irvine, California |
| Authorized Official Name and Position | Kenneth Atsuo Fukuda (OWNER) |
| Authorized Official Contact | 9497860143 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Woodbury Family Optometry 6270 Irvine Blvd Irvine CA 92620-2103 Ph: (949) 786-0143 | Woodbury Family Optometry 6270 Irvine Blvd Irvine CA 92620-2103 Ph: (949) 786-0143 |
| NPI Number | 1194020347 |
|---|---|
| Provider Enumeration Date | 01/20/2011 |
| Last Update Date | 01/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194020347 | NPI | - | NPPES |
| 11134TPL | Other | CA | CA OPTOMETRY LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 11134TPL (California) | Primary |
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