=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386520526
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ISAIAH FUSON OPTOMETRY CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2025
-----------------------------------------------------
Last Update Date | 11/17/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7355 N PALM AVE STE 109
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93711-5770
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-225-2020
-----------------------------------------------------
Fax | 559-227-6411
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7355 N PALM AVE STE 109
-----------------------------------------------------
City | FRESNO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93711-5770
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 559-225-2020
-----------------------------------------------------
Fax | 559-227-6411
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO
-----------------------------------------------------
Name | DR. ISAIAH JACINTO FUSON
-----------------------------------------------------
Credential | OD
-----------------------------------------------------
Telephone | 559-225-2020
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------