Provider Demographics
NPI:1639230923
Name:OSIAS, GARY ALLAN (OD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ALLAN
Last Name:OSIAS
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 1:2687 CASTRO VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-5409
Mailing Address - Country:US
Mailing Address - Phone:510-581-1553
Mailing Address - Fax:510-581-1929
Practice Address - Street 1:2687 CASTRO VALLEY BLVD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-5409
Practice Address - Country:US
Practice Address - Phone:510-581-1553
Practice Address - Fax:510-581-1929
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA07027T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGSD000960Medicaid
CAU25171Medicare UPIN
CACA119849Medicare PIN
CAGSD000960Medicaid