Provider Demographics
NPI:1962492835
Name:TOY, HENNY L (OD)
Entity Type:Individual
Prefix:DR
First Name:HENNY
Middle Name:L
Last Name:TOY
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:925 SECRET RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3465
Mailing Address - Country:US
Mailing Address - Phone:916-421-4111
Mailing Address - Fax:916-422-2185
Practice Address - Street 1:925 SECRET RIVER DR
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3465
Practice Address - Country:US
Practice Address - Phone:916-421-4111
Practice Address - Fax:916-422-2185
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA07076152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4003714Medicaid
CA0274300001Medicare NSC
CAT10466Medicare UPIN