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Organization

PETALUMA EYE CARE OPTOMETRIC ASSOCIATES, INC. A PROFESSIONAL CORP.

Active
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Organization

PETALUMA EYE CARE OPTOMETRIC ASSOCIATES, INC. A PROFESSIONAL CORP.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RONALD LEE HARRIS O.D. (OWNER)
(707) 763-2020
Entity
Organization

Contact information

Practice address
129 KELLER ST, PETALUMA, CA 94952-2934
(707) 763-2020
(707) 763-4735
Mailing address
129 KELLER ST, PETALUMA, CA 94952-2934
(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
—
9300440
—
CA
01
—
P01009218
RAILROAD MEDICARE
CA
Enumeration date
07/30/2009
Last updated
02/14/2014
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