Individual
CRAIG ARTHUR VAN WOERKOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
960 E GREEN ST, SUITE 1000, PASADENA, CA 91106-2401
(626) 793-1483
(626) 793-5449
Mailing address
960 E GREEN ST, SUITE 1000, PASADENA, CA 91106-2401
(626) 793-1483
(626) 793-5449
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
11769T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W21396
MEDICARE PTAN
CA
Enumeration date
03/09/2006
Last updated
11/06/2009
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