Individual
DUANE IVAN KIRK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
423 W MAIN ST, RIPON, CA 95366-2425
(209) 599-3115
(209) 599-3793
Mailing address
423 W MAIN ST, RIPON, CA 95366-2425
(209) 599-3115
(209) 599-3793
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6477T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0064771
—
CA
Enumeration date
12/22/2006
Last updated
07/09/2012
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