Robert M Theaker, O.D Valid NPI

Individual provider · Optometrist · Hollister, CA

NPI

1053321984

Type

Individual (Type 1)

Primary specialty

Optometrist

Specialty group

Eye and Vision Services Providers

Taxonomy code

152W00000X

License number

OPT 9640 TPA (CA)

Sex

Male

Sole proprietor

No

Enumerated

2006-08-09

Last updated

2011-06-09