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Individual
MATTHEW LANGFORD
Active
Individual
MATTHEW LANGFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14030
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811202716
NPI
CA
01
—
FK524Z
P-TAN
CA
Enumeration date
08/16/2010
Last updated
05/18/2012
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