Provider Demographics
NPI:1972725760
Name:DAY, GINA MARIA (OD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:MARIA
Last Name:DAY
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 1:2005 LARKSPUR LANDING CIR
Mailing Address - Street 2:
Mailing Address - City:LARKSPUR
Mailing Address - State:CA
Mailing Address - Zip Code:94939-1802
Mailing Address - Country:US
Mailing Address - Phone:415-925-9091
Mailing Address - Fax:415-925-9092
Practice Address - Street 1:2005 LARKSPUR LANDING CIR
Practice Address - Street 2:
Practice Address - City:LARKSPUR
Practice Address - State:CA
Practice Address - Zip Code:94939-1802
Practice Address - Country:US
Practice Address - Phone:415-925-9091
Practice Address - Fax:415-925-9092
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10121T152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0101210Medicaid
CASD0101210Medicaid