| |
28 Fenton St, Livermore, CA 94550-4144 | |
(925) 449-4000 | |
(925) 606-6603 |
Full Name | |
---|---|
Type | Facility |
Speciality | Eyewear Supplier |
Location | 28 Fenton St, Livermore, California |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1033431424 | NPI | - | NPPES |
00G160910 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Secondary |
332H00000X | Eyewear Supplier | (California) | Primary |
Mailing Address | Practice Location Address |
---|---|
28 Fenton St, Livermore, CA 94550-4144 Ph: (925) 449-4000 | 28 Fenton St, Livermore, CA 94550-4144 Ph: (925) 449-4000 |