Horner, Kerry Alan

Horner, Kerry Alan is an individual health care provider with primary practice located at 1011 Sylvan Ave , Modesto CA 95350-1692. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Horner, Kerry Alan can be contacted via phone (209) 575-2020.

Contact Information

Primary practice address
1011 Sylvan Ave Modesto CA 95350-1692
Phone: (209) 575-2020
Fax: (209) 758-5693
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 5405T California

Profile Details

NPI number 1467441931
LBN Legal business name Horner, Kerry Alan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Jan 28th, 2011 - about 13 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 1467441931 NPPES
California MEDICAID SD0054050

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