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General NPI Number Information
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NPI Number | 1750545406
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Entity Type | Organization
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Legal Business Name | VALLEY CENTER OPTOMETRY APC
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Dates
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Enumeration Date | 07/11/2008
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Last Update Date | 03/14/2012
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Provider Practice Location Address
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Address Line | 29115 VALLEY CENTER RD SUITE E
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City | VALLEY CENTER
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State | CA
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Zip | 92082-6553
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Country | US
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Telephone | 760-751-8771
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Fax | 760-751-8772
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Provider Business Mailing Address
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Address Line | 29115 VALLEY CENTER RD SUITE E
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City | VALLEY CENTER
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State | CA
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Zip | 92082-6553
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Country | US
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Telephone | 760-751-8771
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Fax | 760-751-8772
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT J JOYCE
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Credential | O.D.
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Telephone | 760-751-8771
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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 | 12928
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License Number State | CA
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