Provider Demographics
NPI:1194862664
Name:JULIA WEN OD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:JULIA WEN OD A PROFESSIONAL CORPORATION
Other - Org Name:GOLDEN MILPITAS OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-432-8101
Mailing Address - Street 1:310 BARBER CT
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7922
Mailing Address - Country:US
Mailing Address - Phone:408-432-8101
Mailing Address - Fax:408-432-8103
Practice Address - Street 1:310 BARBER CT
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7922
Practice Address - Country:US
Practice Address - Phone:408-432-8101
Practice Address - Fax:408-432-8103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA113755Medicare PIN