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Individual

CHARLES JEROME HOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
5679 GIBRALTAR DR, PLEASANTON, CA 94588-8547
(925) 463-3937
(925) 947-0957
Mailing address
5679 GIBRALTAR DR, PLEASANTON, CA 94588-8547
(925) 463-3937
(925) 947-0957

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8496T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13514
HEALTH NET
CA
01
211106
EYEMED VISION
CA
Enumeration date
10/05/2006
Last updated
05/04/2016
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