Provider Demographics
NPI:1811024516
Name:VANHOOSE, PATRICK CAMERON (OD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:CAMERON
Last Name:VANHOOSE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7246 CLAIREMONT MESA BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-1007
Mailing Address - Country:US
Mailing Address - Phone:858-292-7193
Mailing Address - Fax:858-292-8247
Practice Address - Street 1:7246 CLAIREMONT MESA BLVD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-1007
Practice Address - Country:US
Practice Address - Phone:858-292-7193
Practice Address - Fax:858-292-8247
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT6576T152WC0802X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD22096AMedicaid
CABZ101AMedicare PIN
CADO869ZMedicare PIN