LAKESIDE OPTOMETRY, PC
Organization (NPI-2)
Active
Optometrist
Provider Information
- NPI Number
1700338779- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 3461 BROOKSIDE RD STE A-1, STOCKTON, CA, 952191741
- Phone
- (209) 451-4305
- Fax
- (209) 622-4283
Specialties & Taxonomies
Optometrist
License: CA #OPT 12656 TPL
Optometrist
Primary License: CA #11714T