Jon G. Wada, O.D.
Optometrist in San Jose, CA. Organization (NPI-2).
NPI number1902967516
StatusActive
Last updated in NPPESMay 15, 2015
Details
- NPI
- 1902967516
- Entity type
- Organization (NPI-2)
- Legal business name
- Jon G. Wada, O.D.
- Organization subpart
- No
- Enumeration date
- Dec 13, 2006
- Last updated
- May 15, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | 9115 | CA | Yes |
| 152WC0802X | Optometrist, Corneal and Contact Management | 9115 | CA | |
| 152WL0500X | Optometrist, Low Vision Rehabilitation | 9115 | CA |
Practice location
2405 Forest AveSan Jose, CA 95128-1500
Phone 408-243-7916 · Fax 408-243-3525
Mailing address
2405 Forest AveSan Jose, CA 95128-1500
Phone 408-243-7916 · Fax 408-243-3525
Authorized official
Jon Gordon Wada
Owner
4082437916
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