Healthcare Provider Details

I. General information

NPI: 1124053152
Provider Name (Legal Business Name): ROBERT ANTHONY TURCIOS JR. O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 CHILPANCINGO PKWY
PLEASANT HILL CA
94523-1300
US

IV. Provider business mailing address

61 CHILPANCINGO PKWY
PLEASANT HILL CA
94523-1300
US

V. Phone/Fax

Practice location:
  • Phone: 925-676-8365
  • Fax: 925-676-3382
Mailing address:
  • Phone: 925-676-8365
  • Fax: 925-676-3382

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number7077T
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number7077T
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number7077T
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number7077T
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number7077T
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number7077T
License Number StateCA
# 7
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number7077T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: