Individual
GARY RICHARD TAXERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1245 THARP RD, YUBA CITY, CA 95993-2640
(530) 674-5273
(530) 674-5275
Mailing address
1245 THARP RD, YUBA CITY, CA 95993-2640
(530) 674-5273
(530) 674-5275
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7072T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD004280
—
CA
05
—
SD0070720
—
CA
01
—
ZZZ07850Z
BCBS GRP
CA
Enumeration date
05/25/2006
Last updated
05/17/2024
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