Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT09532T | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPT09532T | CA |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | OPT09532T | CA |
N | 152WP0200X | Pediatric Optomitrist | OPT09532T | CA |
N | 152WS0006X | Sports Vision | OPT09532T | CA |
N | 152WV0400X | Optomitrist - Vision Therapist | OPT09532T | CA |
N | 152WX0102X | Occupational Vision | OPT09532T | CA |
N | 156FC0801X | Contact Lens Fitter | OPT09532T | CA |
N | 156FX1900X | Orthoptist | OPT09532T | CA |
NPI | 1366463192 |
---|---|
Provider Name | Dr. William J Hyatt |
First Address | San Jose, CA 95123-3212 |
Second Address | San Jose, CA 95123-3212 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 11/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SD0095321 | (05) | CA |