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General NPI Number Information
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NPI Number | 1740441336
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Entity Type | Organization
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Legal Business Name | MOORPARK OPTOMETRIC EYECARE, INC
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Dates
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Enumeration Date | 06/17/2008
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Last Update Date | 12/14/2015
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Provider Practice Location Address
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Address Line | 252 W LOS ANGELES AVE STE G
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City | MOORPARK
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State | CA
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Zip | 93021-1888
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Country | US
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Telephone | 805-520-5497
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Fax | 805-529-4987
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Provider Business Mailing Address
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Address Line | 252 W LOS ANGELES AVE STE G
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City | MOORPARK
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State | CA
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Zip | 93021-1888
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Country | US
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Telephone | 805-520-5497
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. JOHN WILLIAM WOOD
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Credential | O.D.
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Telephone | 805-529-5497
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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 | CA7093T
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License Number State | CA
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