Healthcare Provider Details

I. General information

NPI: 1952394959
Provider Name (Legal Business Name): TOM FRANCIS MIHOK O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2005
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 CALIFORNIA AVE
OAKDALE CA
95361-2946
US

IV. Provider business mailing address

141 CALIFORNIA AVE
OAKDALE CA
95361-2946
US

V. Phone/Fax

Practice location:
  • Phone: 209-847-3051
  • Fax: 209-847-1405
Mailing address:
  • Phone: 209-847-3051
  • Fax: 209-847-1405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5908T
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code156FX1800X
TaxonomyOptician
License Number5908T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: