type, category, person, date, provider, source
| type |
category |
person |
date |
provider |
source |
| prescription |
eye |
Xuewei Jiang |
2021-11-17 |
Maylin Gonzalez, OD — Eyed LA Optometry |
jiang_LA_2021.pdf |
Eyeglass Rx — Xuewei Jiang — 11/17/2021
Provider
- Practice: Eyed LA Optometry
- Doctor: Maylin Gonzalez, OD
- License #: 14297
- Address: 1150 18th Street suite 103, Santa Monica CA 90403
- Phone: (424) 208-3107
Patient Information
- Patient: Xuewei Jiang
- DOB: 03/13/1993
- Address: 11950 Idaho Ave. apt. 113, Los Angeles CA 90025
Exam Details
- Date: 11/17/2021
- Expires: 11/17/2023
- Rx #: 168263508
Rx Details
|
Sphere |
Cyl |
Axis |
Near Add |
Int Add |
H Prism |
V Prism |
| OD |
-3.25 |
|
|
|
|
|
|
| OS |
-3.25 |
-0.25 |
098 |
|
|
|
|
Special Instructions and Recommendations
| Feature |
Value |
| Material |
Polycarbonate |
| Tint |
|
| AR Coating |
Yes |
| Photochromic |
|
| UV Treatment |
Yes |
| Polarized |
|
| LensType |
|
| Instructions |
|
Signed: Maylin Gonzalez, OD
