Waldmire, Mark William
Waldmire, Mark William is an sole proprietor health care provider with primary practice located at 4633 Whitney Ave Suite A, Sacramento CA 95821-4100. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Waldmire, Mark William can be contacted via phone (916) 487-1717.Contact Information
Primary practice address
4633 Whitney Ave Suite A
Sacramento CA 95821-4100
Phone: (916) 487-1717
Fax: (916) 487-3081
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 10098T | California |
Profile Details
| NPI number | 1154313963 |
|---|---|
| LBN Legal business name | Waldmire, Mark William |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 17th, 2005 |
| Last updated | Feb 23rd, 2015 - about 10 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 | 1154313963 | NPPES |
| California | MEDICAID | SD0100980 |
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