MEDICARE: DR. NADINE L NORRIS 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	11378T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598745754
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NADINE L NORRIS O.D.

Provider Business Mailing Address
First Line	:	800 QUINTANA RD
Second Line	:	SUITE 1D
City	:	MORRO BAY
State	:	CA
Zip	:	93442-2300
Country	:	US
Telephone Number	:	805-772-6166
Fax Number	:	805-772-5128

Provider Business Practice Location Address
First Line	:	800 QUINTANA RD
Second Line	:	SUITE 1D
City	:	MORRO BAY
State	:	CA
Zip	:	93442-2300
Country	:	US
Telephone Number	:	805-772-6166
Fax Number	:	805-772-5128

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

Provider Enumeration Date	:	01/21/2006
Last Update Date	:	03/05/2008

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