Tillman, Carol
Tillman, Carol is an individual health care provider with primary practice located at 7117 Brockton Ave , Riverside CA 92506-2615. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Tillman, Carol can be contacted via phone (951) 782-5131.Contact Information
Primary practice address
7117 Brockton Ave
Riverside CA 92506-2615
Phone: (951) 782-5131
Fax: (951) 784-3258
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT8639T | California |
Profile Details
| NPI number | 1770567919 |
|---|---|
| LBN Legal business name | Tillman, Carol |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2005 |
| Last updated | Dec 30th, 2010 - about 14 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 | 1770567919 | NPPES |
| Other | 1730180415 | GOUP NPI |
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