Healthcare Provider Details

I. General information

NPI: 1689661167
Provider Name (Legal Business Name): RICHARD G. JOYCE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

874 SOUTHAMPTON RD
BENICIA CA
94510-1907
US

IV. Provider business mailing address

874 SOUTHAMPTON RD
BENICIA CA
94510-1907
US

V. Phone/Fax

Practice location:
  • Phone: 707-745-6266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number8752T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: