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General NPI Number Information
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NPI Number | 1396964201
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Entity Type | Organization
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Legal Business Name | THOMAS A. FLYNN, 0.D., A PROFESSIONAL CORP.
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 203 WALKER ST SUITE 1
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City | ORLAND
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State | CA
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Zip | 95963-1450
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Country | US
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Telephone | 530-865-9233
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Fax | 530-865-2398
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Provider Business Mailing Address
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Address Line | 203 WALKER ST SUITE 1
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City | ORLAND
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State | CA
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Zip | 95963-1450
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Country | US
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Telephone | 530-865-9233
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Fax | 530-865-2398
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS A FLYNN
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Credential | O.D.
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Telephone | 530-865-9233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6658
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License Number State | CA
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