Davidson, Sandra M
Davidson, Sandra M is an sole proprietor health care provider with primary practice located at 4515 Central Ave Ste 101, Riverside CA 92506-2374. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Low Vision Rehabilitation. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Davidson, Sandra M can be contacted via phone (951) 784-2420.Contact Information
Primary practice address
4515 Central Ave Ste 101
Riverside CA 92506-2374
Phone: (951) 784-2420
Fax: (951) 784-4713
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 9191TPL | California |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 9191TPL | California |
Profile Details
| NPI number | 1164427282 |
|---|---|
| LBN Legal business name | Davidson, Sandra M |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 15th, 2005 |
| Last updated | Oct 23rd, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1164427282 | NPPES |
| California | MEDICAID | SD009191 |
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