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Organization
PETALUMA EYE CARE OPTOMETRIC ASSOCIATES, INC.
Active
Organization
PETALUMA EYE CARE OPTOMETRIC ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RONALD L. HARRIS O.D. (OWNER)
(707) 763-2020
Entity
Organization
Contact information
Practice address
1225 N MCDOWELL BLVD, PETALUMA, CA 94954-1112
(707) 763-2020
(707) 763-4735
Mailing address
1225 N MCDOWELL BLVD, PETALUMA, CA 94954-1112
(707) 763-2020
(707) 763-4735
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
04916T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7789740
—
CA
Enumeration date
10/04/2013
Last updated
12/10/2015
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