Watanabe, Dennis
Watanabe, Dennis is an individual health care provider with primary practice located at 4476 Tweedy Blvd , South Gate CA 90280-6359. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Watanabe, Dennis can be contacted via phone (323) 563-9499.Contact Information
Primary practice address
4476 Tweedy Blvd
South Gate CA 90280-6359
Phone: (323) 563-9499
Fax: (323) 563-9056
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT7702T | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 7702T | California |
Profile Details
| NPI number | 1851404040 |
|---|---|
| LBN Legal business name | Watanabe, Dennis |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 15th, 2006 |
| Last updated | Jul 15th, 2016 - about 8 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 | 1851404040 | NPPES |
| California | MEDICAID | SD007020 | |
| California | MEDICAID | SD0077020 | |
| California | Other | 410046776 | |
| California | Other | 00OPT7702T0 | |
| California | Other | 410046776 |
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