Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT14069TPG | CA |
NPI | 1003816620 |
---|---|
Provider Name | Dr. Valerie Quan |
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 | 26/07/2005 |
Last Update Date | 24/03/2017 |