Provider Demographics
NPI:1598730772
Name:HUTCHINSON, RAY A (OD)
Entity Type:Individual
Prefix:DR
First Name:RAY
Middle Name:A
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:681 ENCINITAS BLVD
Mailing Address - Street 2:#302
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3762
Mailing Address - Country:US
Mailing Address - Phone:760-753-6336
Mailing Address - Fax:760-753-2337
Practice Address - Street 1:681 ENCINITAS BLVD
Practice Address - Street 2:#302
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3762
Practice Address - Country:US
Practice Address - Phone:760-753-6336
Practice Address - Fax:760-753-2337
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2008-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 6963 TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0395180001Medicare NSC
CAOP6963Medicare PIN