Organization
BRUCE D. GAYNOR, M.D., MEDICAL CORPORATION
Active
Other names
Invision Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE DAVID GAYNOR M.D. (PRESIDENT)
(707) 527-8222
Entity
Organization
Contact information
Practice address
4720 HOEN AVE, SANTA ROSA, CA 95405-7867
(707) 527-8222
Mailing address
4720 HOEN AVE, SANTA ROSA, CA 95405-7867
(707) 527-8222
Taxonomy
Speciality
Code
Description
License number
State
156FX1100X
Ophthalmic Technician/Technologist
Primary
G84535
CA
332H00000X
Eyewear Supplier
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G845350
—
CA
01
—
180041368
MEDICARE RAILROAD
CA
Enumeration date
11/17/2006
Last updated
06/17/2008
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