Basic Information
| Provider Information | |||||||||
| NPI: | 1710142062 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HINDS | ||||||||
| FirstName: | NATHAN | ||||||||
| MiddleName: | DANIEL | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 W. WHITTIER BLVD. | ||||||||
| Address2: | #100 | ||||||||
| City: | LA HABRA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906313855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626942500 | ||||||||
| FaxNumber: | 5626942577 | ||||||||
| Practice Location | |||||||||
| Address1: | 121 W. WHITTIER BLVD | ||||||||
| Address2: | #100 | ||||||||
| City: | LA HABRA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 906313855 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5626942500 | ||||||||
| FaxNumber: | 5626942577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/25/2008 | ||||||||
| LastUpdateDate: | 08/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 13518 TLG | CA | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.