Organization
GILBREATH & PARK OPTOMETRY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARILYN K GILBREATH (OPTOMETRIST)
(707) 462-7040
Entity
Organization
Contact information
Practice address
102 SCOTT ST, UKIAH, CA 95482-4316
(707) 462-7040
Mailing address
102 SCOTT ST, UKIAH, CA 95482-4316
(707) 462-7040
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT7782T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD000510
—
CA
Enumeration date
08/13/2007
Last updated
07/07/2009
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