Dr. Rick Wayne Ideta, OD
Optometrist in Fresno, CA. Individual provider (NPI-1).
NPI number1245282011
StatusActive
Last updated in NPPESMar 3, 2010
Details
- NPI
- 1245282011
- Entity type
- Individual (NPI-1)
- Name
- Dr. Rick Wayne Ideta
- Credential
- OD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 17, 2006
- Last updated
- Mar 3, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | OPT8503TPA | CA | Yes |
Practice location
7215 N 1st StSte 101
Fresno, CA 93720-2985
Phone 559-226-3937 · Fax 559-226-8305
Mailing address
7215 N 1st StSte 101
Fresno, CA 93720-2985
Phone 559-226-3937 · Fax 559-226-8305
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