Mark S Ichikawa, Od
Optometrist in Sunnyvale, CA. Organization (NPI-2).
NPI number1477595007
StatusActive
Last updated in NPPESOct 19, 2007
Details
- NPI
- 1477595007
- Entity type
- Organization (NPI-2)
- Legal business name
- Mark S Ichikawa, Od
- Organization subpart
- No
- Enumeration date
- Jun 11, 2006
- Last updated
- Oct 19, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 7965T | CA | Yes |
Other names
- Sunnyvale Optometry (Doing Business As)
Practice location
596 E El Camino RealSuite 2
Sunnyvale, CA 94087-1940
Phone 408-245-6212
Mailing address
596 E El Camino RealSuite 2
Sunnyvale, CA 94087-1940
Phone 408-245-6212 · Fax 408-245-6233
Authorized official
Mark Ichikawa
Sole Proprietor
4082456212
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