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NPI Code Detail

MEDICARE: LANE FUJIMOTO O.D.

MEDICARE: LANE FUJIMOTO 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
1152W00000XOptometrist332NV
2152W00000XOptometrist2273OK

General Provider Information

NPI Number : 1417904723
Entity Type Code : Individual
Provider Name (Legal Business Name) : LANE FUJIMOTO O.D.
Provider Business Mailing Address
First Line : 2016 HUMBLE HOLLOW PL
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89084-3164
Country : US
Telephone Number : 702-254-6919
Fax Number :
Provider Business Practice Location Address
First Line : 6900 N PECOS RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89086-4400
Country : US
Telephone Number : 702-791-9125
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2006
Last Update Date : 06/28/2023

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Directions to “ LANE FUJIMOTO O.D.” Practice Location

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