Anthony J. Revelli O.D.

NPI 1568450575 - Optometrist - 152W00000X

NPI Details
NPI 1568450575
Gender Male
Enumeration Date 10/12/2005
Last Updated 07/08/2007
Entity Type Individual
Active Over 11 years ago
Practice Location
1773 BROADWAY
OAKLAND CA, 94612-2105, US
Phone (510) 832-5625
Fax (510) 832-0614
Business Location
1773 BROADWAY
OAKLAND CA, 94612-2105, US
Phone (510) 832-5625
Fax (510) 832-0614
Toxanomy
Taxonomy Code 152W00000X
License State California
License Number 5452T
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According to our database, Anthony J. Revelli O.D. NPI is 1568450575, taxonomy code is 152W00000X and license number is 5452T, license state is located at California. Anthony J. Revelli O.D. physically located at 1773 Broadway, Oakland CA, 94612-2105. NPI Number Anthony J. Revelli O.D. has the Individual type.

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1568450575 NPI number is provided on an as is basis without warranty of any kind. 1568450575 is maintained by the National Plan & Provider Enumeration System. The contents of Anthony J. Revelli O.D. are for informational purposes only.