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General NPI Number Information
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NPI Number | 1881969582
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Entity Type | Organization
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Legal Business Name | DONALD J. JANIUK O.D.
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Dates
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Enumeration Date | 03/13/2012
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Last Update Date | 03/13/2012
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Provider Practice Location Address
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Address Line | 12845 POWAY RD STE 209
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City | POWAY
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State | CA
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Zip | 92064-4527
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Country | US
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Telephone | 858-748-6210
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Fax | 858-748-6224
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Provider Business Mailing Address
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Address Line | PO BOX 766
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City | POWAY
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State | CA
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Zip | 92074-0766
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Country | US
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Telephone | 858-748-6210
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Fax | 858-748-6224
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Authorized Official
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Title or Position | OWNER
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Name | DR. DONALD JAMES JANIUK
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Credential | O.D.
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Telephone | 858-748-6210
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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 | 5407TLG
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License Number State | CA
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