Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | D7163 | CA |
NPI | 1194932103 |
---|---|
Provider Name | Mr. Alan S Li |
First Address | Dublin, CA 94568-7564 |
Second Address | Dublin, CA 94568-7564 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 08/07/2007 |