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General NPI Number Information
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NPI Number | 1881158210
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Entity Type | Organization
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Legal Business Name | INTEGRATED OCULAR PROSTHETICS
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Dates
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Enumeration Date | 01/30/2019
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Last Update Date | 01/06/2025
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Provider Practice Location Address
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Address Line | 1324 W CENTER AVE
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City | VISALIA
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State | CA
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Zip | 93291-5804
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Country | US
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Telephone | 559-625-3937
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Fax | 559-625-3942
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Provider Business Mailing Address
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Address Line | 11419 N FOWLER AVE
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City | CLOVIS
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State | CA
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Zip | 93619-9544
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Country | US
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Telephone | 559-625-3937
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Fax | 559-625-3942
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Authorized Official
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Title or Position | OCULARIST, OWNER
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Name | MR. ANTONIO L ALCORTA I
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Credential | BCO
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Telephone | 559-625-3937
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1700X
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Taxonomy Name | Ocularist
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License Number |
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License Number State |
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