=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841556289
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAMES M. KANE, O.D., A,P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/10/2012
-----------------------------------------------------
Last Update Date | 04/10/2012
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 30001 CROWN VALLEY PKWY SUITE F
-----------------------------------------------------
City | LAGUNA NIGUEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92677-1723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-495-1610
-----------------------------------------------------
Fax | 949-495-3851
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 30001 CROWN VALLEY PKWY SUITE F
-----------------------------------------------------
City | LAGUNA NIGUEL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92677-1723
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 949-495-1610
-----------------------------------------------------
Fax | 949-495-3851
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER / PRESIDENT
-----------------------------------------------------
Name | DR. JAMES MICHAEL KANE
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 949-495-1610
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 5411T
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------