Healthcare Provider Details

I. General information

NPI: 1710977574
Provider Name (Legal Business Name): JAMES WILLIAM ALMARAZ O D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 02/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41340 BIG BEAR BLVD
BIG BEAR LAKE CA
92315-2820
US

IV. Provider business mailing address

PO BOX 2820
BIG BEAR LAKE CA
92315-2820
US

V. Phone/Fax

Practice location:
  • Phone: 909-866-5701
  • Fax: 909-866-2155
Mailing address:
  • Phone: 909-866-5701
  • Fax: 909-866-2155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6588T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: