MEDICARE: DR. WAYNE W HOEFT 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	152WL0500X	Low Vision Rehabilitation Optometrist	OP4256T	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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	1801851571	OTHER	CA	NPI
4	1114069390	OTHER	CA	FACILITY NPI

General Provider Information

NPI Number	:	1801851571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WAYNE W HOEFT O.D.

Provider Business Mailing Address
First Line	:	907 N SAN FERNANDO BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-4326
Country	:	US
Telephone Number	:	818-846-9075
Fax Number	:	818-846-9010

Provider Business Practice Location Address
First Line	:	907 N SAN FERNANDO BLVD
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91504-4326
Country	:	US
Telephone Number	:	818-846-9075
Fax Number	:	818-846-9010

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	10/10/2007

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