Healthcare Provider Details

I. General information

NPI: 1619404589
Provider Name (Legal Business Name): IDOCS OPTOMETRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40820 WINCHESTER RD STE 1360
TEMECULA CA
92591-5533
US

IV. Provider business mailing address

40820 WINCHESTER RD STE 1360
TEMECULA CA
92591-5533
US

V. Phone/Fax

Practice location:
  • Phone: 951-296-0328
  • Fax: 951-296-0342
Mailing address:
  • Phone: 951-296-0328
  • Fax: 951-296-0342

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRANDON THOMAS ZOECKLER
Title or Position: OWNER
Credential: OD
Phone: 951-296-0328