Individual
GARY MELVIN FREESTONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1850 N RIVERSIDE AVE, SUITE 220, RIALTO, CA 92376-8071
(909) 875-1144
(909) 875-0640
Mailing address
1850 N RIVERSIDE AVE, SUITE 220, RIALTO, CA 92376-8071
(909) 875-1144
(909) 875-0640
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8983TPL
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0089830
—
CA
Enumeration date
11/21/2006
Last updated
05/20/2010
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