John McDonald OD & Tim Robertson OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT9551 T Issued in CA

Legal business name

JOHN MCDONALD OD & TIM ROBERTSON OD

Doing business as

Glenn Optometric Associates

Practice address

245 N Villa Ave
Willows, CA 95988-2607

Phone

(530) 934-3373

Fax

(530) 934-3522

NPI assigned

Sep 8, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Timothy Robertson, O.D.

Title

Optometrist, Owner

Phone

(530) 934-3373

Specialties & licenses 1

Addresses

Other names 1

• GLENN OPTOMETRIC ASSOCIATES Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1114234432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 N VILLA AVE",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882607",
            "telephone_number": "530-934-3373",
            "fax_number": "530-934-3522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 N VILLA AVE",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882607",
            "telephone_number": "530-934-3373",
            "fax_number": "530-934-3522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN MCDONALD OD & TIM ROBERTSON OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-08",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OPTOMETRIST, OWNER",
        "authorized_official_telephone_number": "530-934-3373",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "OPT9551 T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GLENN OPTOMETRIC ASSOCIATES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Yolanda Huerta Medina
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• Veronica Jimenez
• Joanne E Reid MD Inc
• John Pierson DDS Inc
• Eloise Dickey Jones, MA
• Zsolt Horvath Kissevich, DMD
• Michell Danforth Knight, PA C
• Erika Elizabeth Krepelka, LCSW

• Optometrist in Willows, CA
• Providers in Willows, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.