Healthcare Provider Details

I. General information

NPI: 1720131055
Provider Name (Legal Business Name): PATRICIA L. AUSTIN, MD, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1270 ARROYO WAY
WALNUT CREEK CA
94596-4216
US

IV. Provider business mailing address

1270 ARROYO WAY
WALNUT CREEK CA
94596-4216
US

V. Phone/Fax

Practice location:
  • Phone: 925-945-8188
  • Fax: 925-945-0360
Mailing address:
  • Phone: 925-945-8188
  • Fax: 925-945-0360

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberA29698
License Number StateCA

VIII. Authorized Official

Name: PATRICIA L AUSTIN
Title or Position: OPHTHALMOLOGIST
Credential: MD
Phone: 925-945-8188