=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972667962
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | EMIL S LOUIE O.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/21/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 770 E CALAVERAS BLVD
-----------------------------------------------------
City | MILPITAS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95035-5491
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-945-2738
-----------------------------------------------------
Fax | 408-945-5830
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 770 E CALAVERAS BLVD
-----------------------------------------------------
City | MILPITAS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95035-5491
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-945-2738
-----------------------------------------------------
Fax | 408-945-5830
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 6731T
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------