Healthcare Provider Details

I. General information

NPI: 1235092156
Provider Name (Legal Business Name): EDUARDO ALANIZ A.B.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 LIMONITE AVE STE A
JURUPA VALLEY CA
92509-6169
US

IV. Provider business mailing address

3525 MANOR DR
RIVERSIDE CA
92509-1436
US

V. Phone/Fax

Practice location:
  • Phone: 909-268-8275
  • Fax:
Mailing address:
  • Phone: 909-268-8275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number194174
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: