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Organization
JOHN R PREWETT O D INC
Active
Organization
JOHN R PREWETT O D INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN RADER PREWETT OD (OWNER)
(805) 925-9575
Entity
Organization
Contact information
Practice address
1429 S BROADWAY, SANTA MARIA, CA 93454-6913
(805) 925-9575
(805) 739-8886
Mailing address
1429 S BROADWAY, SANTA MARIA, CA 93454-6913
(805) 925-9575
(805) 739-8886
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
CA7312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD005040
—
CA
Enumeration date
02/02/2007
Last updated
08/19/2014
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