Individual
CHAD E STOCKERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
11555 1/2 POTRERO RD, BANNING, CA 92220-6946
(909) 849-4761
Mailing address
11555 1/2 POTRERO RD, BANNING, CA 92220-6946
(909) 849-4761
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TLG14517
CA
Other
Enumeration date
08/08/2012
Last updated
12/16/2014
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