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General NPI Number Information
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NPI Number | 1972243640
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Entity Type | Organization
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Legal Business Name | OPTIMAL MEDICAL CARE INC
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Dates
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Enumeration Date | 03/31/2022
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Last Update Date | 03/29/2023
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Provider Practice Location Address
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Address Line | 1860 S CENTRAL ST STE B
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City | VISALIA
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State | CA
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Zip | 93277-4497
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Country | US
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Telephone | 559-859-6705
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Fax |
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Provider Business Mailing Address
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Address Line | 3320 W GLENDALE AVE
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City | VISALIA
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State | CA
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Zip | 93291-6531
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Country | US
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Telephone | 559-859-6705
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Fax |
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Authorized Official
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Title or Position | TREASURER
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Name | MR. NOURLIE IBUYAT CARLOS
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Credential |
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Telephone | 559-859-6705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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