Provider Demographics
NPI:1568636553
Name:TOYAMA, RICKY DARREN (OD)
Entity Type:Individual
Prefix:DR
First Name:RICKY
Middle Name:DARREN
Last Name:TOYAMA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 827
Mailing Address - Street 2:BOX 1000
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09617-9998
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 827
Practice Address - Street 2:BOX 1000
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09617-9998
Practice Address - Country:US
Practice Address - Phone:01139081-811-6386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-22
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0881152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist