Organization
GARY M. FREESTONE, OD, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY MELVIN FREESTONE O.D. (DOCTOR)
(909) 875-1144
Entity
Organization
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
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
8983TPL
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0089830
—
CA
Enumeration date
10/12/2007
Last updated
05/20/2010
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