Provider Demographics
NPI:1568724318
Name:MANN, HERSHMINDER DHANOA (OD)
Entity Type:Individual
Prefix:DR
First Name:HERSHMINDER
Middle Name:DHANOA
Last Name:MANN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:HERSHMINDER
Other - Middle Name:
Other - Last Name:DHANOA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:10355 TRINITY PARKWAY
Mailing Address - Street 2:(ATTENTION VISION CENTER)
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95219
Mailing Address - Country:US
Mailing Address - Phone:209-957-3060
Mailing Address - Fax:
Practice Address - Street 1:10355 TRINITY PKWY
Practice Address - Street 2:ATTENTION VISION CENTER
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95219-7243
Practice Address - Country:US
Practice Address - Phone:209-957-3060
Practice Address - Fax:209-952-5946
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-07
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003719B152W00000X
IN18003719A152W00000X
CA14595TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist