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General NPI Number Information
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NPI Number | 1548978604
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Entity Type | Organization
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Legal Business Name | REDDING VISION CARE OPTOMETRIC PRACTICE
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Dates
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Enumeration Date | 11/08/2022
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 4805 BECHELLI LANE
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City | REDDING
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State | CA
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Zip | 96002
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Country | US
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Telephone | 530-722-3533
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Fax |
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Provider Business Mailing Address
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Address Line | 3872 THOMASON TRL
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City | REDDING
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State | CA
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Zip | 96002-9684
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Country | US
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Telephone | 530-722-3533
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Fax |
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Authorized Official
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Title or Position | OD/PRESIDENT
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Name | DORA G SZYMANOWICZ NAGY
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Credential | OD
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Telephone | 530-722-3533
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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 |
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License Number State |
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