Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 8170T | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OP8170T | CA |
NPI | 1013918911 |
---|---|
Provider Name | Luelinda Tomlin |
First Address | Long Beach, CA 90815-2820 |
Second Address | Long Beach, CA 90815-2820 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2005 |
Last Update Date | 27/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1013918911 | MEDICARE (01) | CA |
330442849 | BLUE CROSS (01) | CA |
SD0081700 | (05) | CA |
SD0081700 | BLUE SHIELD (01) | CA |
U60405 | (02) | CA |