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Individual

DR. NORMAN JAY MINTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
825 GRAVENSTEIN HWY N, STE 7, SEBASTOPOL, CA 95472-2844
(707) 823-9141
(707) 823-5148
Mailing address
825 GRAVENSTEIN HWY N, STE 7, SEBASTOPOL, CA 95472-2844
(707) 823-9141
(707) 823-5148

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
6087T
CA
152WC0802X
Corneal and Contact Management Optometrist
Primary
6087T
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
SD0060870
CA
Enumeration date
12/04/2006
Last updated
01/27/2009
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