National Provider Identifier Database

ANTHONY J VANDE WYDEVEN, OD – NPI #1861413304
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

ANTHONY J VANDE WYDEVEN, OD
10522 VENICE BLVD
CULVER CITY, CA90232-3308
Phone: 310-838-0521
Fax: 310-839-6201
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X
Corneal and Contact Management 152WC0802X
Occupational Vision 152WX0102X
Pediatrics 152WP0200X
Sports Vision 152WS0006X

* Indicates primary specialty

NPI Profile & details for ANTHONY J VANDE WYDEVEN

NPI Number 1861413304
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 07/21/2006
Last updated 10/15/2009 - About 17 years ago
Sole proprietor1 Yes
Identifiers
  • CA License #: 8132T
  • CA Medicaid: SD0081320
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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