Provider Demographics
NPI:1659616399
Name:METROPOLITAN OPTOMETRY INC
Entity Type:Organization
Organization Name:METROPOLITAN OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WU
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:626-839-0908
Mailing Address - Street 1:1380 FULLERTON RD
Mailing Address - Street 2:#103
Mailing Address - City:ROWLAND HEIGHTS
Mailing Address - State:CA
Mailing Address - Zip Code:91748-1248
Mailing Address - Country:US
Mailing Address - Phone:626-839-0908
Mailing Address - Fax:626-839-1528
Practice Address - Street 1:1380 FULLERTON RD
Practice Address - Street 2:#103
Practice Address - City:ROWLAND HEIGHTS
Practice Address - State:CA
Practice Address - Zip Code:91748-1248
Practice Address - Country:US
Practice Address - Phone:626-839-0908
Practice Address - Fax:626-839-1528
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2016-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14260261Q00000X
CA12811261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center