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Individual

DR. DAVID GRISHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OD, MS, FAAO,FCOVD-A

Contact information

Practice address
615 B ST, SUITE 2, SAN RAFAEL, CA 94901-3805
(415) 459-2020
(415) 459-2021
Mailing address
615 B ST, SUITE 2, SAN RAFAEL, CA 94901-3805
(415) 459-2020
(415) 459-2021

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5110
CA
152WL0500X
Low Vision Rehabilitation Optometrist
5110
CA
152WP0200X
Pediatric Optometrist
5110
CA
152WS0006X
Sports Vision Optometrist
5110
CA
152WV0400X
Vision Therapy Optometrist
5110
CA
152WX0102X
Occupational Vision Optometrist
5110
CA
156FX1100X
Ophthalmic Technician/Technologist
5110
CA

Other

Enumeration date
07/29/2011
Last updated
07/29/2011
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