MEDICARE: DR. DONALD BRIAN APODACA 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
1	152WC0802X	Corneal and Contact Management Optometrist	7926T	CA
2	152WL0500X	Low Vision Rehabilitation Optometrist	7926T	CA

General Provider Information

NPI Number	:	1831275916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DONALD BRIAN APODACA O.D.

Provider Business Mailing Address
First Line	:	215 WICHITA AVE
Second Line	:	UNIT 205
City	:	HUNTINGTON BEACH
State	:	CA
Zip	:	92648-2800
Country	:	US
Telephone Number	:	714-967-4796
Fax Number	:

Provider Business Practice Location Address
First Line	:	1900 E 4TH ST
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3910
Country	:	US
Telephone Number	:	714-967-4786
Fax Number	:

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

Provider Enumeration Date	:	10/31/2006
Last Update Date	:	11/30/2021

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