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Individual
TIMOTHY LEWIS SANDERS
Active
Individual
TIMOTHY LEWIS SANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5762T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0057620
—
CA
Enumeration date
12/16/2005
Last updated
05/20/2013
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