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General NPI Number Information
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NPI Number | 1124355094
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Entity Type | Organization
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Legal Business Name | JAMES B MAYER
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 100 N RANCHO RD STE 1
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-6011
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Country | US
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Telephone | 805-495-3937
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Fax | 805-373-9843
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Provider Business Mailing Address
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Address Line | 100 N RANCHO RD STE 1
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City | THOUSAND OAKS
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State | CA
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Zip | 91362-6011
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Country | US
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Telephone | 805-495-3937
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Fax | 805-373-9843
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES B MAYER
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Credential | OD
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Telephone | 805-495-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 7800
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152WP0200X
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Taxonomy Name | Pediatric Optometrist
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License Number | 7800
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152WV0400X
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Taxonomy Name | Vision Therapy Optometrist
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License Number | 7800
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7800
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License Number State | CA
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