Healthcare Provider Details

I. General information

NPI: 1154632529
Provider Name (Legal Business Name): STEVEN WARNE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 02/13/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 W EAST AVE
CHICO CA
95926-7201
US

IV. Provider business mailing address

605 W EAST AVE
CHICO CA
95926-7201
US

V. Phone/Fax

Practice location:
  • Phone: 530-895-1727
  • Fax: 530-895-1506
Mailing address:
  • Phone: 530-895-1727
  • Fax: 530-895-1506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberT-201-TA-848
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: