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General NPI Number Information
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NPI Number | 1811344971
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Entity Type | Organization
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Legal Business Name | DR SCOTT E GITTINS OD & DR JOHN COEN OD INC
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Dates
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Enumeration Date | 05/18/2016
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Last Update Date | 07/08/2016
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Provider Practice Location Address
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Address Line | 6809 FIVE STAR BLVD STE 100A
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City | ROCKLIN
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State | CA
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Zip | 95677-2687
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Country | US
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Telephone | 916-624-2020
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Fax | 916-624-3027
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Provider Business Mailing Address
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Address Line | 6809 FIVE STAR BLVD STE 100A
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City | ROCKLIN
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State | CA
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Zip | 95677-2687
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Country | US
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Telephone | 916-624-2020
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Fax | 916-624-3027
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT E GITTINS
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Credential | OD
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Telephone | 916-624-2020
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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 | OPT9752TLG
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License Number State | CA
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