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Individual

DR. JEFFREY JAY CAPELLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
390 NORTH LOOP DR, FORT IRWIN, CA 92310
(760) 383-5333
(760) 383-5710
Mailing address
3824 BUENA VISTA ST APT B, FORT IRWIN, CA 92310-1872
(614) 795-1643
(760) 383-5333

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
3595T1393
OH
152W00000X
Optometrist
Primary
7504TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0497583
OH
Enumeration date
11/07/2006
Last updated
05/23/2022
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