Provider Demographics
NPI:1326195074
Name:WORON, HAROLD JAMES (OD)
Entity Type:Individual
Prefix:
First Name:HAROLD
Middle Name:JAMES
Last Name:WORON
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 1:863 S WOLFE RD
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-8164
Mailing Address - Country:US
Mailing Address - Phone:408-732-8009
Mailing Address - Fax:
Practice Address - Street 1:1855 41ST AVE
Practice Address - Street 2:STE G-11
Practice Address - City:CAPITOLA
Practice Address - State:CA
Practice Address - Zip Code:95010-2511
Practice Address - Country:US
Practice Address - Phone:831-475-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT4607152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT09713Medicare UPIN