Provider Demographics
NPI:1508907551
Name:TERESA M. GERARD O.D., INC.
Entity Type:Organization
Organization Name:TERESA M. GERARD O.D., INC.
Other - Org Name:OPTOMETRIC CARE OF SACRAMENTO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GERARD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-635-1823
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8473152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU39265Medicare UPIN