Moore, Samuel David

Moore, Samuel David is an individual health care provider with primary practice located at 1414 E Main St , Santa Maria CA 93454-4806. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Moore, Samuel David can be contacted via phone (805) 925-2637.

Contact Information

Primary practice address
1414 E Main St Santa Maria CA 93454-4806
Phone: (805) 925-2637
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 10654T California

Profile Details

NPI number 1881637445
LBN Legal business name Moore, Samuel David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2006
Last updated Dec 27th, 2007 - about 18 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 1881637445 NPPES
California Other 1312330002 MEDICARE DMERC
California MEDICAID SD0106540 MEDICARE DMERC

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