Provider Demographics
NPI:1255359816
Name:OKU, RUSSELL K (OD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:K
Last Name:OKU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1145 BRAMFORD CT
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4353
Mailing Address - Country:US
Mailing Address - Phone:909-860-5644
Mailing Address - Fax:
Practice Address - Street 1:2207 S ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:MONTEREY PARK
Practice Address - State:CA
Practice Address - Zip Code:91754-6803
Practice Address - Country:US
Practice Address - Phone:323-266-0222
Practice Address - Fax:323-266-1846
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8557T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist