Funk, Gary R.

Funk, Gary R. is an individual health care provider with primary practice located at 7862 El Cajon Blvd , La Mesa CA 91942-6712. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Funk, Gary R. can be contacted via phone (619) 644-6405.

Contact Information

Primary practice address
7862 El Cajon Blvd La Mesa CA 91942-6712
Fax: (619) 461-5158
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT7802T California

Profile Details

NPI number 1851301964
LBN Legal business name Funk, Gary R.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2006
Last updated Jun 19th, 2013 - about 13 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 1851301964 NPPES
California MEDICAID SD0078020

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