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General NPI Number Information
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NPI Number | 1558354720
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Entity Type | Individual
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Provider Name | JAMES S. LINVILLE O.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 08/29/2008
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Provider Practice Location Address
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Address Line | 579 4TH AVE
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City | GUSTINE
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State | CA
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Zip | 95322-1143
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Country | US
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Telephone | 209-854-3771
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Fax | 209-854-3772
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Provider Business Mailing Address
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Address Line | 579 4TH AVE
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City | GUSTINE
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State | CA
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Zip | 95322-1143
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Country | US
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Telephone | 209-854-3771
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Fax | 209-854-3772
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPT 8781 TPA
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License Number State | CA
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