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Individual
DR. RANDALL B WATKINS
Active
Individual
DR. RANDALL B WATKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT 5613T TPL
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
03558
MEDICAL EYE SERVICES
CA
01
—
2413
DAVIS VISION
CA
01
—
8069
SAFEGUARD
CA
01
—
CV07521
SPECTERA
CA
05
—
SD0056130
—
CA
Enumeration date
12/19/2005
Last updated
10/24/2011
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