Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 152W00000X | Optometrist | | 13216 TPA | CALIFORNIA | No |
| 2 | 152WC0802X | Optometrist | Corneal and Contact Management | 13216 TPA | CALIFORNIA | No |
| 3 | 152WP0200X | Optometrist | Pediatrics | 13216 TPA | CALIFORNIA | No |
| 4 | 152WX0102X | Optometrist | Occupational Vision | 13216 TPA | CALIFORNIA | Yes |