NPI | 1003806068 |
---|---|
Entity Type | Organization |
Authorized Contact | PENNY DOW Billing Manager 707-575-3800 |
Organization Subpart ? | No |
Primary Taxonomy | 207W00000X Ophthalmology (Licence: CA G32243) |
Additional Taxonomies | 207W00000X Ophthalmology (Licence: CA G57122) |
207W00000X Ophthalmology (Licence: CA G32019) | |
152W00000X Optometrist (Licence: CA 8739T) | |
152WL0500X Optometrist, Low Vision Rehabilitation (Licence: CA 8817T) | |
152W00000X Optometrist (Licence: CA T10471) | |
Enumeration Date | 2005-10-21 |
Last Update Date | 2008-05-01 |