Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 7077T | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 7077T | CA |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | 7077T | CA |
N | 152WP0200X | Pediatric Optomitrist | 7077T | CA |
N | 152WS0006X | Sports Vision | 7077T | CA |
N | 152WV0400X | Optomitrist - Vision Therapist | 7077T | CA |
N | 152WX0102X | Occupational Vision | 7077T | CA |
NPI | 1124053152 |
---|---|
Provider Name | Dr. Robert Anthony Turcios Jr. |
First Address | Pleasant Hill, CA 94523-1300 |
Second Address | Pleasant Hill, CA 94523-1300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/07/2006 |
Last Update Date | 30/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7077T | STATE LICENCE NUMBER (01) | CA |
SD0070770 | (05) | CA |
T10467 | (02) | CA |