Provider Demographics
NPI:1871304089
Name:LAUREN M. SOOHOO OPTOMETRIC CORP.
Entity type:Organization
Organization Name:LAUREN M. SOOHOO OPTOMETRIC CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:MONSANTO
Authorized Official - Last Name:SOOHOO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-452-7807
Mailing Address - Street 1:808 WESTMORELAND DR
Mailing Address - Street 2:
Mailing Address - City:MONTEBELLO
Mailing Address - State:CA
Mailing Address - Zip Code:90640-2452
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4651 FIRESTONE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH GATE
Practice Address - State:CA
Practice Address - Zip Code:90280-3446
Practice Address - Country:US
Practice Address - Phone:714-452-7807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-16
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty