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Organization
TRACY OPTOMETRY GROUP, INC
Active
Organization
TRACY OPTOMETRY GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID C MOLINE 0.D. (PRESIDENT)
(209) 835-7446
Entity
Organization
Contact information
Practice address
36 W 10TH ST, TRACY, CA 95376-3902
(209) 835-7446
(209) 835-3572
Mailing address
36 W 10TH ST, TRACY, CA 95376-3902
(209) 835-7446
(209) 835-3572
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
COR1056
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD005210
—
CA
Enumeration date
04/25/2007
Last updated
02/14/2008
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