Healthcare Provider Details

I. General information

NPI: 1770312027
Provider Name (Legal Business Name): JOYCE ZHUANG CRUZ OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2790 CABOT DR STE 135
CORONA CA
92883-0862
US

IV. Provider business mailing address

130 E CHAPMAN AVE APT 340
FULLERTON CA
92832-1993
US

V. Phone/Fax

Practice location:
  • Phone: 951-277-2774
  • Fax:
Mailing address:
  • Phone: 240-786-8863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT35767-TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: