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General NPI Number Information
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NPI Number | 1144005380
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Entity Type | Organization
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Legal Business Name | AVAKS OPTOMETRY
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Dates
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Enumeration Date | 08/28/2023
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 3000 COUNTRYSIDE DR
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City | TURLOCK
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State | CA
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Zip | 95380-8402
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Country | US
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Telephone | 209-216-4042
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 BURMAN DR
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City | TURLOCK
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State | CA
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Zip | 95382-9275
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Country | US
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Telephone | 708-308-8892
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SERGE G AVAK
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Credential | OD
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Telephone | 708-308-8892
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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 |
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License Number State |
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