NPI | 1063542777 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID W VASTINE President 510-444-0603 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: CA OPT5762) |
Additional Taxonomies | 152W00000X Optometrist (Licence: CA OPT9734) |
207W00000X Ophthalmology (Licence: CA G39000) | |
207W00000X Ophthalmology (Licence: CA G17966) | |
Enumeration Date | 2007-03-06 |
Last Update Date | 2020-08-22 |