Provider Demographics
NPI:1790856250
Name:HOLCOMB, JUDITH GRAY (OD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:GRAY
Last Name:HOLCOMB
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:31306 MACKINAW ST
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94587-2591
Mailing Address - Country:US
Mailing Address - Phone:510-489-6743
Mailing Address - Fax:650-299-2453
Practice Address - Street 1:1150 VETERANS BLVD
Practice Address - Street 2:KAISER HOSPITAL
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2037
Practice Address - Country:US
Practice Address - Phone:650-299-2406
Practice Address - Fax:650-299-2453
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5877T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist