MEDICARE: MARGIT CRAIG O.D.

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	2004020414	MO
2	152W00000X	Optometrist	OPT 14355 TPL	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	:	1124024294
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGIT CRAIG O.D.

Provider Business Mailing Address
First Line	:	1877 E DAILY DR
Second Line	:	STE D-1
City	:	CAMARILLO
State	:	CA
Zip	:	93010-6205
Country	:	US
Telephone Number	:	805-987-5300
Fax Number	:	805-987-5330

Provider Business Practice Location Address
First Line	:	4353 PARK TERRACE DR
Second Line	:	STE 150
City	:	WESTLAKE VILLAGE
State	:	CA
Zip	:	91361-4631
Country	:	US
Telephone Number	:	805-987-5300
Fax Number	:	805-987-5330

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

Provider Enumeration Date	:	06/23/2005
Last Update Date	:	10/23/2013

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