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General NPI Number Information
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NPI Number | 1831767821
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Entity Type | Individual
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Provider Name | OLIVIA K GADA OD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 07/03/2024
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Provider Practice Location Address
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Address Line | 8220 SAN PEDRO DR NE STE 220
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2480
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Country | US
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Telephone | 505-797-4466
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1506
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City | CHEHALIS
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State | WA
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Zip | 98532-0409
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Country | US
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Telephone | 360-242-3008
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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 | 0003688
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT-2024-0005
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License Number State | NM
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