Individual
JUDI ANN GILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OPTICIAN
Contact information
Practice address
210 N EL CIRCULO AVE, PATTERSON, CA 95363-2521
(209) 895-4900
(209) 895-4901
Mailing address
210 N EL CIRCULO AVE, PATTERSON, CA 95363-2521
(209) 895-4900
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CLD8516
OPTICIAN
CA
01
—
RDO71019
OPTICIAN
CA
Enumeration date
09/04/2019
Last updated
09/04/2019
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