Provider Demographics
NPI:1902981517
Name:DEAR, WEYLAND (OD)
Entity Type:Individual
Prefix:DR
First Name:WEYLAND
Middle Name:
Last Name:DEAR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 BLOSSOM HILL RD
Mailing Address - Street 2:STE 7
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95118-3806
Mailing Address - Country:US
Mailing Address - Phone:408-295-0246
Mailing Address - Fax:408-292-0507
Practice Address - Street 1:1375 BLOSSOM HILL RD
Practice Address - Street 2:STE 7
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95118-3806
Practice Address - Country:US
Practice Address - Phone:408-295-0246
Practice Address - Fax:408-292-0507
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2018-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10684T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0106840Medicaid
CASD0106840Medicare ID - Type UnspecifiedMEDICARE ID
CASD0106840Medicaid