Provider Demographics
NPI:1932226099
Name:OZAKI, GARY K (OD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:K
Last Name:OZAKI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:4550 TASSAJARA RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4610
Mailing Address - Country:US
Mailing Address - Phone:925-479-0400
Mailing Address - Fax:925-479-0401
Practice Address - Street 1:4550 TASSAJARA RD
Practice Address - Street 2:SUITE C
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-4610
Practice Address - Country:US
Practice Address - Phone:925-479-0400
Practice Address - Fax:925-479-0401
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8113T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA430285Medicare UPIN
CAGOD000849Medicare ID - Type Unspecified