MEDICARE: DR. RICHARD COLE ASTON O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT 8058 TPA	CA

General Provider Information

NPI Number	:	1518939156
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD COLE ASTON O.D.

Provider Business Mailing Address
First Line	:	345B S MCDOWELL BLVD
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94954-3507
Country	:	US
Telephone Number	:	707-778-1961
Fax Number	:	707-778-1369

Provider Business Practice Location Address
First Line	:	345B S MCDOWELL BLVD
Second Line	:
City	:	PETALUMA
State	:	CA
Zip	:	94954-3507
Country	:	US
Telephone Number	:	707-778-1961
Fax Number	:	707-778-1369

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2006
Last Update Date	:	07/08/2007

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