Organization
JAMES R. DALLAS, O.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES RONALD DALLAS O.D. (OWNER)
(760) 256-8014
Entity
Organization
Contact information
Practice address
1356 E MAIN ST, #A, BARSTOW, CA 92311-3220
(760) 256-8014
Mailing address
1356 E MAIN ST, #A, BARSTOW, CA 92311-3220
(760) 256-8014
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD003190
—
CA
Enumeration date
07/01/2006
Last updated
02/05/2009
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