Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 13719TLG | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 13719TLG | CA |
N | 152WP0200X | Pediatric Optomitrist | 13719TLG | CA |
N | 152WS0006X | Sports Vision | 13719TLG | CA |
N | 152WV0400X | Optomitrist - Vision Therapist | 13719TLG | CA |
NPI | 1346478591 |
---|---|
Provider Name | Dr. Linda Luong Bellomy |
First Address | Pomona, CA 91766-2007 |
Second Address | Pomona, CA 91766-2007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2009 |
Last Update Date | 25/10/2016 |