Individual
ANTHONY J. REVELLI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1773 BROADWAY, OAKLAND, CA 94612-2105
(510) 832-5625
(510) 832-0614
Mailing address
1773 BROADWAY, OAKLAND, CA 94612-2105
(510) 832-5625
(510) 832-0614
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5452T
CA
Other
Enumeration date
10/12/2005
Last updated
07/08/2007
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