| |
396 Colusa Ave, Kensington, CA 94707-1209 | |
(510) 527-1714 | |
(510) 527-1715 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 396 Colusa Ave, Kensington, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801825591 | NPI | - | NPPES |
1619911047 | Other | CA | NPI (INDIVIDUAL) |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 5955 (California) | Secondary |
152W00000X | Optometrist | 9134 (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
396 Colusa Ave, Kensington, CA 94707-1209 Ph: (510) 527-1714 | 396 Colusa Ave, Kensington, CA 94707-1209 Ph: (510) 527-1714 |
Dr. Lawrence Stamer Thal, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 291 Arlington Ave, Kensington, CA 94707 Phone: 510-527-1714 Fax: 510-527-1715 |