Provider Demographics
NPI:1003899006
Name:FORTE, JAMES (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:FORTE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1395 W LACEY BLVD
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5904
Mailing Address - Country:US
Mailing Address - Phone:559-585-3937
Mailing Address - Fax:559-582-3645
Practice Address - Street 1:321 C ST
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2931
Practice Address - Country:US
Practice Address - Phone:559-924-2666
Practice Address - Fax:559-924-0266
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4865T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0048650Medicaid
CASD0048650Medicare PIN
CASD0048650Medicaid
CA0256010001Medicare NSC