Organization
EARLE BAUM CENTER OF THE BLIND INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALLAN BRENNER (PRESIDENT/CEO)
(707) 523-3222
Entity
Organization
Contact information
Practice address
4539 OCCIDENTAL RD, SANTA ROSA, CA 95401-5635
(707) 523-3222
(707) 636-2768
Mailing address
4539 OCCIDENTAL RD, SANTA ROSA, CA 95401-5635
(707) 523-3222
(707) 636-2768
Taxonomy
Speciality
Code
Description
License number
State
152WL0500X
Low Vision Rehabilitation Optometrist
Primary
8817T
CA
Other
Enumeration date
02/03/2010
Last updated
02/10/2015
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