| |
3126 Professional Dr, Suite 300, Auburn, CA 95603-2407 | |
(530) 885-3767 | |
(530) 885-3201 |
Full Name | |
---|---|
Type | Facility |
Speciality | Specialist |
Location | 3126 Professional Dr, Auburn, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023206166 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | OPT6581T (California) | Secondary |
174400000X | Specialist | A45204 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
3126 Professional Dr, Suite 300, Auburn, CA 95603-2407 Ph: (530) 885-3767 | 3126 Professional Dr, Suite 300, Auburn, CA 95603-2407 Ph: (530) 885-3767 |