Park, David L
Park, David L is an individual health care provider with primary practice located at 102 Scott St , Ukiah CA 95482-4316. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Park, David L can be contacted via phone (707) 462-7040.Contact Information
Primary practice address
102 Scott St
Ukiah CA 95482-4316
Phone: (707) 462-7040
Fax: (707) 462-7089
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT7782T | California |
Profile Details
| NPI number | 1558358937 |
|---|---|
| LBN Legal business name | Park, David L |
| Credentials | O.D., M.S. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Mar 15th, 2012 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1558358937 | NPPES |
| California | MEDICAID | SD0077820 |
Popular Providers
-
Mothershed, Fred H
3353 N Gloster St , Tupelo MS 38804-9735 -
Brudner, Peter N.
425 W Central Ave , Lompoc CA 93436-2805 -
Vargas, Joe A.
789 S Dora St , Ukiah CA 95482-5335 -
Keplinger, Brian Leigh
15 Grandview Dr Ste D, Frankfort KY 40601-3235 -
Varley, Richard W
508 W Chickasha Ave , Chickasha OK 73018-2412 -
Gilbreath, Marilyn K.
102 Scott St , Ukiah CA 95482-4316 -
Sude, Jerome
3510 Manchester Rd , Coventry Township OH 44319-1415 -
Doss, Renee E
102 Scott St , Ukiah CA 95482-4316