Wacker, Richard Thue
Wacker, Richard Thue is an individual health care provider with primary practice located at 3801 Miranda Ave Vapahcs Optom/112, Palo Alto CA 94304-1207. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Low Vision Rehabilitation. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Wacker, Richard Thue can be contacted via phone (650) 493-5000.Contact Information
Primary practice address
3801 Miranda Ave Vapahcs Optom/112
Palo Alto CA 94304-1207
Phone: (650) 493-5000
Fax: (650) 852-3228
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 8134T | California |
| Eye and Vision Services Providers / Low Vision Rehabilitation | 152WL0500X | 8134T | California |
Profile Details
| NPI number | 1326076506 |
|---|---|
| LBN Legal business name | Wacker, Richard Thue |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 28th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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 | 1326076506 | NPPES |
| California | MEDICAID | SD0081340 |
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