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Healthcare Organization Stored source record

LARKSPUR LANDING OPTOMETRY

2005 LARKSPUR LANDING CIR, LARKSPUR, CA, 949391802

atlas:atm_npi_1306837117

Block 2013Block Group 2Census Tract 1212Marin CountyCaliforniaUnited States

What is stored

phone
415-925-9091
status
A
address
2005 LARKSPUR LANDING CIR, LARKSPUR, CA, 949391802
fax
415-925-9092
npi
1306837117
license
10121T
taxonomy
Optometrist, Vision Therapy
other names
[]
last updated
2020-08-22
license state
CA
taxonomy code
152WV0400X
all taxonomies
["Optometrist, Vision Therapy"]
enumeration date
2005-10-31
enumeration type
NPI-2
practice locations
0
authorized official
EDWARD HAACK
organizational subpart
NO

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{
  "fax": "415-925-9092",
  "npi": "1306837117",
  "phone": "415-925-9091",
  "status": "A",
  "address": "2005 LARKSPUR LANDING CIR, LARKSPUR, CA, 949391802",
  "license": "10121T",
  "taxonomy": "Optometrist, Vision Therapy",
  "other_names": [],
  "last_updated": "2020-08-22",
  "license_state": "CA",
  "taxonomy_code": "152WV0400X",
  "all_taxonomies": [
    "Optometrist, Vision Therapy"
  ],
  "enumeration_date": "2005-10-31",
  "enumeration_type": "NPI-2",
  "practice_locations": 0,
  "authorized_official": "EDWARD HAACK",
  "organizational_subpart": "NO"
}