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Individual

DR. GARY BRUCE MYERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
1140 MAIN ST STE 207, RAMONA, CA 92065-2168
(760) 789-1191
(760) 789-1216
Mailing address
1140 MAIN ST STE 207, RAMONA, CA 92065-2168
(760) 789-1191
(760) 789-1216

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7998T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
OP7998
BLUE SHIELD
CA
05
SD0079980
CA
Enumeration date
07/05/2006
Last updated
01/15/2009
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