Wada, Garrett Scott

Wada, Garrett Scott is an individual health care provider with primary practice located at 936 S Brookhurst St , Anaheim CA 92804-4305. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wada, Garrett Scott can be contacted via phone (714) 533-2525.

Contact Information

Primary practice address
936 S Brookhurst St Anaheim CA 92804-4305
Phone: (714) 533-2525
Fax: (714) 242-9564
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 10097T California

Profile Details

NPI number 1033172903
LBN Legal business name Wada, Garrett Scott
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Jul 9th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033172903 NPPES
California MEDICAID SD010097

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