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General NPI Number Information
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NPI Number | 1033470497
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Entity Type | Organization
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Legal Business Name | DELA CRUZ OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 06/01/2012
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Last Update Date | 06/01/2012
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Provider Practice Location Address
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Address Line | 1535 LANDESS AVE STE 117
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City | MILPITAS
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State | CA
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Zip | 95035-8208
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Country | US
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Telephone | 408-934-5938
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Fax | 408-934-5939
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Provider Business Mailing Address
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Address Line | 1535 LANDESS AVE STE 117
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City | MILPITAS
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State | CA
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Zip | 95035-8208
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Country | US
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Telephone | 408-934-5938
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Fax | 408-934-5939
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | EMMANUEL DELA CRUZ II
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Credential | O.D.
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Telephone | 408-934-5938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 13964TLG
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License Number State | CA
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