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Individual
MARK WILLIAM WALDMIRE
Active
Individual
MARK WILLIAM WALDMIRE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10098T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0100980
—
CA
Enumeration date
08/17/2005
Last updated
02/23/2015
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