Mark A Jury, Od A Optometric Professional Corporation

LBN: Mark A Jury, Od A Optometric Professional Corporation
Mark A Jury, Od A Optometric Professional Corporation is an health care organization with primary practice located at 23905 Clinton Keith Rd Ste #115, Wildomar CA 92595-7897. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Mark A Jury, Od A Optometric Professional Corporation can be contacted via phone (951) 304-9733, or through Jury, Mark A via phone (951) 304-9733.

Contact Information

Primary practice address
23905 Clinton Keith Rd Ste #115 Wildomar CA 92595-7897
Phone: (951) 304-9733
Fax: (866) 741-5945
Website:
Map and Directions
Authorized official contact:
Name: Jury, Mark A Doctor of Optometry (OD)
Phone: (951) 304-9733

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OPT9583 California

Profile Details

NPI number 1376627000
LBN Legal business name Mark A Jury, Od A Optometric Professional Corporation
DBA Doing business as
Authorized official Jury, Mark A Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 25th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376627000 NPPES
California MEDICAID SD0095831

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