Provider Demographics
NPI:1043312200
Name:JANIUK, DONALD JAMES (OD, FCOVD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JAMES
Last Name:JANIUK
Suffix:
Gender:M
Credentials:OD, FCOVD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92074-0766
Mailing Address - Country:US
Mailing Address - Phone:858-748-6210
Mailing Address - Fax:858-748-6224
Practice Address - Street 1:12845 POWAY RD
Practice Address - Street 2:SUITE 209
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4529
Practice Address - Country:US
Practice Address - Phone:858-748-6210
Practice Address - Fax:858-748-6224
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA5407T152WC0802X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT70019Medicare UPIN
CA4386990001Medicare NSC