MEDICARE: DR. MICHAEL J JONES OD

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
1	152W00000X	Optometrist	CAOPT8751T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083607949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL J JONES OD

Provider Business Mailing Address
First Line	:	15786 SPRINGDALE ST
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-1316
Country	:	US
Telephone Number	:	714-892-2987
Fax Number	:	801-996-5178

Provider Business Practice Location Address
First Line	:	15786 SPRINGDALE ST
Second Line	:
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92649-1316
Country	:	US
Telephone Number	:	714-892-2987
Fax Number	:	801-996-5178

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/25/2005
Last Update Date	:	08/03/2010

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