Provider Demographics
NPI:1780061085
Name:TOM F. MIHOK
Entity type:Organization
Organization Name:TOM F. MIHOK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:TOM
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:MIHOK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:209-847-3051
Mailing Address - Street 1:141 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:CA
Mailing Address - Zip Code:95361-2946
Mailing Address - Country:US
Mailing Address - Phone:209-847-3051
Mailing Address - Fax:209-847-1405
Practice Address - Street 1:141 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:OAKDALE
Practice Address - State:CA
Practice Address - Zip Code:95361-2946
Practice Address - Country:US
Practice Address - Phone:209-847-3051
Practice Address - Fax:209-847-1405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-06
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5908TPG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty