MEDICARE: DR. DEBRA C PATTISON 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	10653	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410030767	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1760485429
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBRA C PATTISON O.D.

Provider Business Mailing Address
First Line	:	215 VERNON ST
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95678-2632
Country	:	US
Telephone Number	:	916-783-8144
Fax Number	:	916-783-8179

Provider Business Practice Location Address
First Line	:	215 VERNON ST
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95678-2632
Country	:	US
Telephone Number	:	916-783-8144
Fax Number	:	916-783-8179

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	05/21/2024

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