MEDICARE: GARY M LOUIE OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6732T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033253067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY M LOUIE OD

Provider Business Mailing Address
First Line	:	34724 ALVARADO NILES RD
Second Line	:
City	:	UNION CITY
State	:	CA
Zip	:	94587-4502
Country	:	US
Telephone Number	:	510-489-5510
Fax Number	:	510-489-5658

Provider Business Practice Location Address
First Line	:	34724 ALVARADO NILES RD
Second Line	:
City	:	UNION CITY
State	:	CA
Zip	:	94587-4502
Country	:	US
Telephone Number	:	510-489-5510
Fax Number	:	510-489-5658

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/15/2007
Last Update Date	:	02/07/2012

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Directions to “ GARY M LOUIE OD” Practice Location

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