Thall, Marc Stewart
Thall, Marc Stewart is an sole proprietor health care provider with primary practice located at 10316 Sepulveda Blvd , Mission Hills CA 91345. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Thall, Marc Stewart can be contacted via phone (818) 361-4020.Contact Information
Primary practice address
10316 Sepulveda Blvd
Mission Hills CA 91345
Phone: (818) 361-4020
Fax: (818) 361-3966
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT 5607 TPA | California |
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT5607TPA | California |
Profile Details
| NPI number | 1669576716 |
|---|---|
| LBN Legal business name | Thall, Marc Stewart |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 11th, 2006 |
| Last updated | Jun 5th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669576716 | NPPES |
| Other | 3992 | MESC | |
| Other | 56-2563452 | MESC | |
| MEDICAID | SD0056070 | MESC |
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