Provider Demographics
NPI:1609083435
Name:CALIFORNIA OPHTHALMIC LASER ASSOCIATES, MEDICAL PC
Entity type:Organization
Organization Name:CALIFORNIA OPHTHALMIC LASER ASSOCIATES, MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBILL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-398-6066
Mailing Address - Street 1:303 W JOAQUIN AVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SAN LEANDRO
Mailing Address - State:CA
Mailing Address - Zip Code:94577-3642
Mailing Address - Country:US
Mailing Address - Phone:510-895-9657
Mailing Address - Fax:510-895-9680
Practice Address - Street 1:303 W JOAQUIN AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:SAN LEANDRO
Practice Address - State:CA
Practice Address - Zip Code:94577-3642
Practice Address - Country:US
Practice Address - Phone:510-895-9657
Practice Address - Fax:510-895-9680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty