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DR. JAMES PATRICK FURCOLOW O.D.

>> Optometrist >> Eye and Vision Services Providers

Registrant NPI Number: 1871600395

Individual Registrant:
DR. JAMES PATRICK FURCOLOW O.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
17829 SANTIAGO BLVD  VILLA PARK, CA 92861 US
Tel: 714-998-6610  Fax: 714-998-3275

Contact information for business:
17829 SANTIAGO BLVD  VILLA PARK, CA 92861-4133 US
Tel: 714-998-6610  Fax: 714-998-3275

Registration Information:
NPI: 1871600395
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y152W00000XEye and Vision Services Providers
Optometrist
CA5392

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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