Provider Demographics
NPI:1245448794
Name:WOTKYNS, MARGARET KEHOE (OD)
Entity type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:KEHOE
Last Name:WOTKYNS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2927 WHEELER ST
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-1810
Mailing Address - Country:US
Mailing Address - Phone:510-710-2974
Mailing Address - Fax:
Practice Address - Street 1:2222 EAST ST.
Practice Address - Street 2:SUITE 365
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2170
Practice Address - Country:US
Practice Address - Phone:925-687-8280
Practice Address - Fax:925-687-9744
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 7241 TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist