# DR. JARED ROBERT WIDDER

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1073048963
- **Gender:** Man
- **Credential:** D.O.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171000000X | Military Health Care Provider | — | NULL | — |
| 207W00000X | Ophthalmology Physician | 16655 | CA | Yes |
| 207WX0009X | Glaucoma Specialist (Ophthalmology) Physician | 16655 | CA | — |

## Other

- **Enumeration date:** 04/27/2017
- **Last updated:** 07/14/2023