Organization · NPI-2
Integrated Ocular Prosthetics
Technician/Technologist, Ocularist · Visalia, CA
NPI number1881158210
StatusActive
Last updated in NPPESJan 6, 2025
Details
- NPI
- 1881158210
- Entity type
- Organization (NPI-2)
- Legal business name
- Integrated Ocular Prosthetics
- Organization subpart
- No
- Enumeration date
- Jan 30, 2019
- Certification date
- Jan 6, 2025
- Last updated
- Jan 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 156FX1700X | Technician/Technologist, Ocularist | – | – | Yes |
Practice location
1324 W Center AveVisalia, CA 93291-5804
Phone 559-625-3937 · Fax 559-625-3942
Mailing address
11419 N Fowler AveClovis, CA 93619-9544
Phone 559-625-3937 · Fax 559-625-3942
Other practice locations
11419 N Fowler Ave
Clovis, CA 93619-9544
Clovis, CA 93619-9544
Phone 559-625-3937 · Fax 559-625-3942
Authorized official
Antonio L Alcorta
Ocularist, Owner
5596253937
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