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Individual
DR. PETER O IM
Active
Individual
DR. PETER O IM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11597T
CA
152W00000X
Optometrist
2912AT
OR
152W00000X
Optometrist
3677
WA
Other
Enumeration date
01/25/2006
Last updated
02/27/2019
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