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GENA LYNN DAVIS O.D.
>> Optometrist >> Eye and Vision Services ProvidersRegistrant NPI Number: 1902050669
Individual Registrant: GENA LYNN DAVIS O.D.
Gender: F
Sole Proprietor
Gender: F
Sole Proprietor
Location and contact information for practice:
39150 OCEAN DRIVE SUITE 2A GUALALA, CA 95445 US
Tel: 707-884-3937 Fax: --
Tel: 707-884-3937 Fax: --
Contact information for business:
PO BOX 1088 GUALALA, CA 95445-1088 US
Tel: 707-884-3937 Fax: --
Tel: 707-884-3937 Fax: --
Registration Information:
NPI: 1902050669
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 152W00000X | Eye and Vision Services Providers Optometrist | CA | 8214T |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
