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Individual

DR. CHRISTINA SUSANNE WILMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
2222 BANCROFT EXT, BERKELEY, CA 94720-4303
(510) 643-2020
(510) 642-9422
Mailing address
2222 BANCROFT EXT, BERKELEY, CA 94720-4303
(510) 643-2020
(510) 642-9422

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10667 TPG
CA
152W00000X
Optometrist
483
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10667 TLG
STATE LICENSE
CA
01
483
STATE LICENSE NUMBER
NM
Enumeration date
12/20/2006
Last updated
03/07/2023
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