Portman, Dodd Randall
Portman, Dodd Randall is an individual health care provider with primary practice located at 1190 Scott Blvd , Santa Clara CA 95050-4562. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Portman, Dodd Randall can be contacted via phone (408) 241-3510.Contact Information
Primary practice address
1190 Scott Blvd
Santa Clara CA 95050-4562
Phone: (408) 241-3510
Fax: (408) 247-2605
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 8010T | California |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 8010T | California |
Profile Details
| NPI number | 1659341097 |
|---|---|
| LBN Legal business name | Portman, Dodd Randall |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1659341097 | NPPES |
| California | Other | 8010T | OPTOMETRY LICENSE # |
| California | Other | BI923Z | OPTOMETRY LICENSE # |
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