Simmons, Deric Crane

Simmons, Deric Crane is an individual health care provider with primary practice located at 8907 Warner Ave Suite 125, Huntington Beach CA 92647-5075. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Simmons, Deric Crane can be contacted via phone (714) 962-6400.

Contact Information

Primary practice address
8907 Warner Ave Suite 125 Huntington Beach CA 92647-5075
Phone: (714) 962-6400
Fax: (714) 596-5972
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 9360T California

Profile Details

NPI number 1801886841
LBN Legal business name Simmons, Deric Crane
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801886841 NPPES
California MEDICAID SD0093600

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