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General NPI Number Information
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NPI Number | 1679620231
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Entity Type | Individual
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Provider Name | ALAN DAVID WILL O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/05/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1264-A AUTO PKWY
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City | ESCONDIDO
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State | CA
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Zip | 92029
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Country | US
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Telephone | 760-743-5209
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Fax |
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Provider Business Mailing Address
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Address Line | 11455 LUCERA PL
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City | SAN DIEGO
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State | CA
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Zip | 92127-1449
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Country | US
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Telephone | 858-673-9884
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Fax | 858-673-4682
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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 | 7388T
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License Number State | CA
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