Healthcare Provider Details

I. General information

NPI: 1952032971
Provider Name (Legal Business Name): JOEL MUNOZ OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2022
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3060 E 9TH ST
OAKLAND CA
94601-2905
US

IV. Provider business mailing address

6028 S 74TH AVE
SUMMIT IL
60501-1523
US

V. Phone/Fax

Practice location:
  • Phone: 510-535-5500
  • Fax:
Mailing address:
  • Phone: 708-691-4385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number35465
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: