Tracy Tom Park, O.D. Valid NPI
Individual provider · Optometrist · Garden Grove, CA
- NPI
- 1770896011
- Type
- Individual (Type 1)
- Primary specialty
- Optometrist
- Specialty group
- Eye and Vision Services Providers
- Taxonomy code
- 152W00000X
- License number
- 14009 (CA)
- Sex
- Female
- Sole proprietor
- Yes
- Enumerated
- 2010-07-15
- Last updated
- 2014-06-09
Practice location
12302 Garden Grove Blvd, Suite 6
Garden Grove, CA 92843-1802
(714) 590-2020