Doctor Name: | MR. VENERANDO TORRES GATDULA |
NPI Number: | 1144460395 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OPTICIAN |
License Number: | DIO-246 |
Business Practice Address: | 94-260 Waipahu Depot St Waipahu, HI - 967973009 |
Business Phone Number: | 8084697690 |
Business Fax Number: | |
Mailing Address: | 94-1397 Waipahu St, WAIPAHU |
State: | HI |
Postal Code: | 967973551 |
Phone Number: | 8084697690 |
Fax Number: | |
NPI Enumeration Date: | 03/01/2009 |
NPI Last Update Date: | 03/01/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | DIO-246 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | HI |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |