Provider Demographics
NPI:1952394959
Name:MIHOK, TOM FRANCIS (OD)
Entity Type:Individual
Prefix:DR
First Name:TOM
Middle Name:FRANCIS
Last Name:MIHOK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 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
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-24
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5908T152W00000X, 156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0059080Medicaid
CA2216OtherMEDICAL EYE SERVICES
CAMI67356OtherCLARITY VISION
CA919432OtherEYEMED VISION
CA45584OtherSAFEGUARD
CAU58783Medicare UPIN
CA0750070001Medicare NSC
CA2216OtherMEDICAL EYE SERVICES