Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT33735TGL | CA |
NPI | 1003337486 |
---|---|
Provider Name | Jennifer Elizabeth Ding |
First Address | Oakland, CA 94610-1435 |
Second Address | San Francisco, CA 94122-1715 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2017 |
Last Update Date | 06/07/2017 |