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General NPI Number Information
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NPI Number | 1477749265
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER A RUZICKA & LAURA LACEY
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Dates
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Enumeration Date | 09/14/2007
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 4180 TREAT BLVD SUITE B
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City | CONCORD
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State | CA
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Zip | 94518-1858
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Country | US
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Telephone | 925-682-0319
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Fax | 925-676-0966
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Provider Business Mailing Address
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Address Line | 4180 TREAT BLVD SUITE B
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City | CONCORD
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State | CA
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Zip | 94518-1858
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Country | US
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Telephone | 925-682-0319
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Fax | 925-676-0966
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Authorized Official
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Title or Position | PARTNER
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Name | DR. CHRISTOPHER ALAN RUZICKA
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Credential | O.D.
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Telephone | 925-682-0319
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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 | 8844T
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License Number State | CA
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