MEDICARE: DR. JAY ROY DELANEY O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	OPT10309T	CA

General Provider Information

NPI Number	:	1720086135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAY ROY DELANEY O.D.

Provider Business Mailing Address
First Line	:	2305 CAMINO RAMON
Second Line	:	#202
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1396
Country	:	US
Telephone Number	:	925-866-2020
Fax Number	:	925-866-2026

Provider Business Practice Location Address
First Line	:	2305 CAMINO RAMON
Second Line	:	#202
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1396
Country	:	US
Telephone Number	:	925-866-2020
Fax Number	:	925-866-2026

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2005
Last Update Date	:	06/05/2009

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