Provider Demographics
NPI:1750679247
Name:MURPHY, ALLISYN S (OD)
Entity Type:Individual
Prefix:DR
First Name:ALLISYN
Middle Name:S
Last Name:MURPHY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2395 IRON POINT RD STE 110
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8769
Mailing Address - Country:US
Mailing Address - Phone:916-850-8349
Mailing Address - Fax:
Practice Address - Street 1:2395 IRON POINT RD STE 110
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8769
Practice Address - Country:US
Practice Address - Phone:916-850-8349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-18
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14232152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6963150001Medicare NSC
CAFJ589ZMedicare PIN
CAHE527AMedicare PIN