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Organization

DOUGLAS A LIDDICOAT INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DOUGLAS A LIDDICOAT MD (PRESIDENT)
(831) 728-2020
Entity
Organization

Contact information

Practice address
160 GREEN VALLEY RD, SUITE 202, FREEDOM, CA 95019-3160
(831) 728-2020
(831) 728-4739
Mailing address
160 GREEN VALLEY RD, SUITE 202, FREEDOM, CA 95019-3160
(831) 728-2020
(831) 728-4739

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C19432
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
OOC194320
CA
Enumeration date
06/01/2007
Last updated
08/22/2020
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