Davidson, Sandra M

Davidson, Sandra M is an sole proprietor health care provider with primary practice located at 4515 Central Ave Ste 101, Riverside CA 92506-2374. She recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Low Vision Rehabilitation. Eye and Vision Services Providers / Optometrist is her primary health care specialty. Davidson, Sandra M can be contacted via phone (951) 784-2420.

Contact Information

Primary practice address
4515 Central Ave Ste 101 Riverside CA 92506-2374
Phone: (951) 784-2420
Fax: (951) 784-4713
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 9191TPL California
Eye and Vision Services Providers / Low Vision Rehabilitation 152WL0500X 9191TPL California

Profile Details

NPI number 1164427282
LBN Legal business name Davidson, Sandra M
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 15th, 2005
Last updated Oct 23rd, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164427282 NPPES
California MEDICAID SD009191

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