Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 09753T | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 09753T | CA |
NPI | 1013240878 |
---|---|
Provider Name | Dr. Susan Elizabeth Caul |
First Address | Redwood City, CA 94062-1552 |
Second Address | Redwood City, CA 94062-1552 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2009 |
Last Update Date | 11/09/2009 |