=====================================================
General NPI Number Information
=====================================================
NPI Number | 1134150980
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THOMAS H MURPHY OD INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2006
-----------------------------------------------------
Last Update Date | 07/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5500 SUNRISE BLVD STE 400
-----------------------------------------------------
City | CITRUS HEIGHTS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95610-7641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-726-2020
-----------------------------------------------------
Fax | 916-726-3937
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5500 SUNRISE BLVD STE 400
-----------------------------------------------------
City | CITRUS HEIGHTS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95610-7641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-726-2020
-----------------------------------------------------
Fax | 916-726-3937
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | JOHN S BASKETT
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 916-929-5909
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------