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General NPI Number Information
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NPI Number | 1780061085
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Entity Type | Organization
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Legal Business Name | TOM F. MIHOK
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Dates
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Enumeration Date | 05/06/2015
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Last Update Date | 05/06/2015
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Provider Practice Location Address
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Address Line | 141 CALIFORNIA AVE
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City | OAKDALE
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State | CA
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Zip | 95361-2946
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Country | US
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Telephone | 209-847-3051
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Fax | 209-847-1405
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Provider Business Mailing Address
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Address Line | 141 CALIFORNIA AVE
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City | OAKDALE
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State | CA
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Zip | 95361-2946
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Country | US
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Telephone | 209-847-3051
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Fax | 209-847-1405
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Authorized Official
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Title or Position | OWNER/ DOCTOR
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Name | TOM FRANCIS MIHOK
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Credential | O.D.
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Telephone | 209-847-3051
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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 | 5908TPG
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License Number State | CA
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