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General NPI Number Information
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NPI Number | 1689816282
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Entity Type | Organization
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Legal Business Name | RONALD B. MORI, O.D.
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 4617 FREEPORT BLVD SUITE D
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City | SACRAMENTO
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State | CA
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Zip | 95822-2015
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Country | US
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Telephone | 916-452-4439
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Fax | 916-452-3432
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Provider Business Mailing Address
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Address Line | 4617 FREEPORT BLVD SUITE D
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City | SACRAMENTO
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State | CA
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Zip | 95822-2015
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Country | US
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Telephone | 916-452-4439
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Fax | 916-452-3432
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Authorized Official
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Title or Position | QWNER
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Name | RONALD B. MORI
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Credential | O.D.
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Telephone | 916-452-4439
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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 | 5184
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License Number State | CA
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