Provider Demographics
NPI:1285849265
Name:GERARD, TERESA M (OD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:M
Last Name:GERARD
Suffix:
Gender:F
Credentials:OD
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Mailing Address - Street 1:10921 OLSON DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-5659
Mailing Address - Country:US
Mailing Address - Phone:916-635-1823
Mailing Address - Fax:916-635-0912
Practice Address - Street 1:10921 OLSON DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-5659
Practice Address - Country:US
Practice Address - Phone:916-635-1823
Practice Address - Fax:916-635-0912
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA8473152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU39265Medicare UPIN