Healthcare Provider Details

I. General information

NPI: 1891774311
Provider Name (Legal Business Name): JAMES LELAND FLICKNER OD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2006
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

48 W ROMIE LN
SALINAS CA
93901-2317
US

IV. Provider business mailing address

48 W ROMIE LANE
SALINAS CA
93901
US

V. Phone/Fax

Practice location:
  • Phone: 831-424-0834
  • Fax: 831-424-4994
Mailing address:
  • Phone: 831-424-0831
  • Fax: 831-424-4994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number01989
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: