Healthcare Provider Details

I. General information

NPI: 1952416711
Provider Name (Legal Business Name): THOMAS A. FLYNN, O.D. A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 WALKER ST STE 1
ORLAND CA
95963-1457
US

IV. Provider business mailing address

203 WALKER ST. SUITE 1
ORLAND CA
95963-1457
US

V. Phone/Fax

Practice location:
  • Phone: 530-865-9233
  • Fax: 530-865-2398
Mailing address:
  • Phone: 530-865-9233
  • Fax: 530-865-2398

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberCORPORATE # 968
License Number StateCA

VIII. Authorized Official

Name: DR. THOMAS A FLYNN
Title or Position: PRESIDENT
Credential: O.D.
Phone: 530-865-9233