Fontana Optometric Group, Inc. | |
16866 Seville Ave, Fontana, CA 92335-3561 | |
(909) 350-1524 | |
(909) 350-8546 |
Full Name | Fontana Optometric Group, Inc. |
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Type | Facility |
Speciality | Optometrist |
Location | 16866 Seville Ave, Fontana, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972688513 | NPI | - | NPPES |
YYY48781Y | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 06988 (California) | Primary |
Provider Name | Jason Timbol Flores |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1851429922 PECOS PAC ID: 2062433709 Enrollment ID: I20051209000492 |
Provider Name | Douglas J Leo |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1215012869 PECOS PAC ID: 9133477524 Enrollment ID: I20180801001170 |
Provider Name | Richard James Gray |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1174802425 PECOS PAC ID: 5294992665 Enrollment ID: I20180822002257 |
Mailing Address | Practice Location Address |
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Fontana Optometric Group, Inc. 8381 Juniper Ave Ste 100, Fontana, CA 92335-3431 Ph: (909) 428-2020 | Fontana Optometric Group, Inc. 16866 Seville Ave, Fontana, CA 92335-3561 Ph: (909) 350-1524 |
Junyao Xu, OD Optometrist Medicare: Medicare Enrolled Practice Location: 8381 Juniper Ave Unit 100, Fontana, CA 92335 Phone: 909-428-2020 | |
Tammy M Tran, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Gary J Jacobson, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Mai Nguyen, O.d., Optometric Corporation Optometrist Medicare: Not Enrolled in Medicare Practice Location: 15070 Summit Ave Ste 400, Fontana, CA 92336 Phone: 909-538-9246 | |
Arlene Sarroca Arcega, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 | |
Dr. Matthew M. Enos, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 8190 Mango Ave, Fontana, CA 92335 Phone: 909-350-2020 | |
Theprangsy Nantha, OD Optometrist Medicare: Medicare Enrolled Practice Location: 9961 Sierra Ave, Fontana, CA 92335 Phone: 909-427-3910 |