Kensington Optometry Inc
Organization Active NPI Optometrist · Kensington, CA
NPI 1801825591 · NPPES record last updated Oct 21, 2016
Key facts
- NPI
- 1801825591
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 9134 (CA)
- Legal business name
- KENSINGTON OPTOMETRY INC
- Practice address
- 396 Colusa Ave
Kensington, CA 94707-1209 - Phone
- (510) 527-1714
- Fax
- (510) 527-1715
- NPI assigned
- Jul 3, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Russell Norman Cotteral, OD
- Title
- President, Owner, Optometrist
- Phone
- (510) 527-1714
Practitioners 1
-
Lawrence Stamer Thal, O.D.
National Provider Directory
Locations
291 Arlington Ave
Kensington, CA 94707
Phone (510) 338-6000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 5955 | CA | |
| Optometrist |
152W00000X | 9134 | CA | Yes |
Addresses
Primary practice location
396 Colusa Ave
Kensington, CA 94707-1209
Mailing address
396 Colusa Ave
Kensington, CA 94707-1209
Phone (510) 527-1714
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619911047 | Other | CA | NPI (INDIVIDUAL) |
Other names
- Russell Cotteral dba Kensington Optometry
Other providers in Kensington, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.