Chris Iwata, OD

Organization Active NPI Optometrist · Angels Camp, CA

NPI 1306390265 · NPPES record last updated Aug 9, 2016

Key facts

NPI
1306390265
Entity type
Organization (NPI type 2)
Primary specialty
Optometrist 152W00000X
License
5700TLG (CA)
Legal business name
CHRIS IWATA, OD
Practice address
595 Stanislaus Ave Ste C
Angels Camp, CA 95222-9356
Phone
(209) 736-0908
NPI assigned
Aug 9, 2016
Organization subpart
No

Authorized official

Name
Pauline Kitagawa
Title
Manager
Phone
(209) 736-0908

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist
Group: 193400000X SINGLE SPECIALTY GROUP
152W00000X 5700TLG CA Yes

Addresses

Primary practice location

595 Stanislaus Ave Ste C
Angels Camp, CA 95222-9356

Mailing address

595 Stanislaus Ave Ste C
Angels Camp, CA 95222-9356
Phone (209) 736-0908

Other providers in Angels Camp, CA

All providers in Angels Camp, CA · Optometrist in California

Sources for this page

Verify at the official NPI Registry.