Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 8021T | CA |
NPI | 1073648861 |
---|---|
Provider Name | Dr. Irene Nora Sang |
First Address | South Pasadena, CA 91030-3072 |
Second Address | South Pasadena, CA 91030-3072 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03072 | MEDICAL EYE SERVICES (01) | CA |
2535 | DAVIS VISION (01) | CA |
8021 | FACEY MEDICAL GROUP (01) | CA |
T70246 | (02) |