Healthcare Provider Details

I. General information

NPI: 1053312652
Provider Name (Legal Business Name): D DANZ & SONS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2005
Last Update Date: 02/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6741 N WILLOW AVE SUITE 101
FRESNO CA
93710-5955
US

IV. Provider business mailing address

6741 N WILLOW AVE SUITE 101
FRESNO CA
93710-5955
US

V. Phone/Fax

Practice location:
  • Phone: 559-252-1770
  • Fax: 559-252-1781
Mailing address:
  • Phone: 559-252-1770
  • Fax: 559-252-1781

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1700X
TaxonomyOcularist
License Number89-218-14
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number89-218-14
License Number StateCA

VIII. Authorized Official

Name: MR. ANTONIO L. ALCORTA
Title or Position: PRESIDENT/BOARD CERTIFIED OCULARIST
Credential: B.C.O.
Phone: 559-252-1770