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
Fax: (951) 784-3258
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770567919 NPPES
Other 1730180415 GOUP NPI

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