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General NPI Number Information
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NPI Number | 1114218997
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Entity Type | Organization
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Legal Business Name | MACARIUS, MAX & DANIEL, LLC
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 7350 MADISON AVE
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City | FAIR OAKS
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State | CA
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Zip | 95628-3309
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Country | US
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Telephone | 916-863-1534
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Fax | 561-828-8367
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Provider Business Mailing Address
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Address Line | 3081 S. CONGRESS AVENUE
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City | PALM SPRINGS
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State | FL
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Zip | 33461
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Country | US
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Telephone | 561-275-2020
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DANIEL STANTON
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Credential |
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Telephone | 561-275-2001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 11554
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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