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Organization
MARK A JURY, OD A OPTOMETRIC PROFESSIONAL CORPORATION
Active
Organization
MARK A JURY, OD A OPTOMETRIC PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A JURY OD (OPTOMETRIST)
(951) 304-9733
Entity
Organization
Contact information
Practice address
23905 CLINTON KEITH RD, STE #115, WILDOMAR, CA 92595-7897
(951) 304-9733
(866) 741-5945
Mailing address
23905 CLINTON KEITH RD, STE #115, WILDOMAR, CA 92595-7897
(951) 304-9733
(866) 741-5945
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT9583
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0095831
—
CA
Enumeration date
10/25/2006
Last updated
08/22/2020
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