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DAVID JASON BORDER O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1003171661

Individual Registrant:
 DAVID JASON BORDER O.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
3960 MITCHELL RD  CERES, CA 95307-9420 US
Tel: 209-641-7813  Fax: 209-538-1967

Contact information for business:
4117 SPRING MOUNTAIN CT  MODESTO, CA 95356-8774 US
Tel: 661-713-0287  Fax: 209-538-1967

Registration Information:
NPI: 1003171661
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
CA14444

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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