Provider Demographics
NPI:1073754974
Name:BENJAMIN S THRELKELD
Entity Type:Organization
Organization Name:BENJAMIN S THRELKELD
Other - Org Name:CAMBRIDGE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:HSIAO
Authorized Official - Last Name:THRELKELD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:650-323-6772
Mailing Address - Street 1:250 CAMBRIDGE AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1549
Mailing Address - Country:US
Mailing Address - Phone:650-323-6772
Mailing Address - Fax:650-323-6775
Practice Address - Street 1:250 CAMBRIDGE AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1549
Practice Address - Country:US
Practice Address - Phone:650-323-6772
Practice Address - Fax:650-323-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-23
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11278T152W00000X
CA11147T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty