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General NPI Number Information
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NPI Number | 1760176077
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Entity Type | Individual
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Provider Name | LUKE DAVID PAGE O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2023
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Last Update Date | 06/08/2023
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Provider Practice Location Address
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Address Line | 2770 EUREKA WAY STE 100
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City | REDDING
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State | CA
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Zip | 96001-0252
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Country | US
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Telephone | 530-222-7271
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Fax |
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Provider Business Mailing Address
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Address Line | 3222 MAJESTIC OAK CIR
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City | COTTONWOOD
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State | CA
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Zip | 96022-9568
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Country | US
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Telephone | 530-366-6303
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 35510
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License Number State | CA
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