Wampler, Matthew Logan

Wampler, Matthew Logan is an sole proprietor health care provider with primary practice located at 2101 Stone Blvd Ste. 150, West Sacramento CA 95691-4044. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wampler, Matthew Logan can be contacted via phone (916) 372-3090.

Contact Information

Primary practice address
2101 Stone Blvd Ste. 150 West Sacramento CA 95691-4044
Fax: (916) 372-8055
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT9619T California

Profile Details

NPI number 1134190689
LBN Legal business name Wampler, Matthew Logan
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 31st, 2006
Last updated Jan 17th, 2008 - about 18 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 1134190689 NPPES
California MEDICAID SD0096190
California Other SD0096190

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