person
Mr. Gary Daniel Waldrop, OPTICIAN
Optician in Shasta Lake, California
NPI 1861516007

Gary Daniel Waldrop is a Optician based in Shasta Lake, CA and is specialized in Optician. Gary Daniel Waldrop practices in Shasta Lake, CA and has the professional credentials of OPTICIAN. The NPI Number for Gary Daniel Waldrop is 1861516007 and holds a License No. 141463 (California).

The current practice location address for Gary Daniel Waldrop is 4601 Shasta Dam Blvd, Shasta Lake, CA and can be reached out via phone at 530-275-8581 and via fax at 530-275-8596.

Location: 4601 Shasta Dam Blvd, Shasta Lake, CA, 96019-9413
person
Provider Profile Details
NPI Number
1861516007
Provider Name
Gary Daniel Waldrop
Credential
OPTICIAN
Provider Entity Type
Individual
Gender
Male
Address
4601 Shasta Dam Blvd, Shasta Lake, CA, 96019-9413
Phone Number
530-275-8581
Fax Number
530-275-8596
Provider Enumeration Date
03/16/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
9419 01 CA MEDICAL EYE SERVICES
DX067260F 05 CA
CA4661 01 CA EYE MED PROVIDER NUMBER
institution
Provider Business Practice Location Address Details
Address
4601 Shasta Dam Blvd
City
State
Zip
96019-9413
Phone Number
530-275-8581
Fax Number
530-275-8596
person
Provider Business Mailing Address Details
Address
4601 Shasta Dam Blvd
City
State
Zip
96019-9413
Phone Number
530-275-8581
Fax Number
530-275-8596
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
License No.
141463 (California)
Definition
Definition to come...
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