Provider Demographics
NPI:1336110956
Name:ALFORD, DAVID PAUL (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PAUL
Last Name:ALFORD
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 1:937 E MAIN ST
Mailing Address - Street 2:SUITE # 102
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5323
Mailing Address - Country:US
Mailing Address - Phone:805-922-1923
Mailing Address - Fax:805-922-2395
Practice Address - Street 1:937 E MAIN ST
Practice Address - Street 2:SUITE # 102
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5323
Practice Address - Country:US
Practice Address - Phone:805-922-1923
Practice Address - Fax:805-922-2395
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11271T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0112710Medicaid
CASD0112710Medicaid