NPI 1477966026

Andrew Wilson, OD

Practitioner Optometrist Camarillo, CA

Practice location

Address: 4000 Calle Tecate #100, Camarillo, CA 93012-5282
Phone: (805) 482-1136
Fax: (805) 388-8499
Mailing address: 4000 Calle Tecate Suite 100, Camarillo, CA 93012-5282

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 14926 (CA)

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Registry record

NPI: 1477966026
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Jun 2014
Record last updated: 30 Oct 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.