Provider Demographics
NPI:1770615270
Name:RYE, MARVIN C (OD)
Entity type:Individual
Prefix:
First Name:MARVIN
Middle Name:C
Last Name:RYE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:3995 N FRESNO ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93726-4031
Mailing Address - Country:US
Mailing Address - Phone:559-227-7919
Mailing Address - Fax:559-227-7921
Practice Address - Street 1:3995 N FRESNO ST
Practice Address - Street 2:SUITE 108
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4031
Practice Address - Country:US
Practice Address - Phone:559-227-7919
Practice Address - Fax:559-227-7921
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2015-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA7046T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU47091Medicare UPIN
CAU47091Medicare UPIN