Bruner, Gary Wayne

Bruner, Gary Wayne is an sole proprietor health care provider with primary practice located at 6100 Sunrise Mall , Citrus Heights CA 95610-6906. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bruner, Gary Wayne can be contacted via phone (916) 721-1466.

Contact Information

Primary practice address
6100 Sunrise Mall Citrus Heights CA 95610-6906
Phone: (916) 721-1466
Fax: (916) 726-0658
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 8066T California

Profile Details

NPI number 1033259387
LBN Legal business name Bruner, Gary Wayne
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 7th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033259387 NPPES
California MEDICAID SD0080660

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