Individual
GILLIAN A PENITENTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ABOC
Contact information
Practice address
411 30TH ST STE G-2, OAKLAND, CA 94609-3301
(510) 836-2353
(510) 836-3517
Mailing address
411 30TH ST STE G-2, OAKLAND, CA 94609-3301
(510) 836-2353
(510) 836-3517
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
061013
CA
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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