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NPI Code Detail

MEDICARE: JAYSON MADRIAGA O.D.

MEDICARE: JAYSON MADRIAGA O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist15380CA

General Provider Information

NPI Number : 1083095699
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAYSON MADRIAGA O.D.
Provider Business Mailing Address
First Line : 3070 WOODS WAY
Second Line :
City : SAN JOSE
State : CA
Zip : 95148-2645
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6900 PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number : 702-791-9000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2015
Last Update Date : 10/26/2021

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Directions to “ JAYSON MADRIAGA O.D.” Practice Location

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