Provider Demographics
NPI:1124098835
Name:HIRSCH, CARL (OD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1613 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-4118
Mailing Address - Country:US
Mailing Address - Phone:925-932-4362
Mailing Address - Fax:925-932-8567
Practice Address - Street 1:1613 LOCUST ST
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-4118
Practice Address - Country:US
Practice Address - Phone:925-932-4362
Practice Address - Fax:925-932-8567
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6046152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WV0400XEye and Vision Services ProvidersOptometristVision Therapy