Provider Demographics
NPI:1952856049
Name:THOMPSON, DARCY (RDO)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 EL CAMINO REAL STE 103
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94301-2335
Mailing Address - Country:US
Mailing Address - Phone:650-326-9111
Mailing Address - Fax:
Practice Address - Street 1:75-167 HUALALAI RD
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1714
Practice Address - Country:US
Practice Address - Phone:808-329-9308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CASL40636156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician