Provider Demographics
NPI:1407911282
Name:FROUMIS, NICHOLAS A (OD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:A
Last Name:FROUMIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:130 S SUNNYVALE AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6249
Mailing Address - Country:US
Mailing Address - Phone:408-736-3802
Mailing Address - Fax:408-736-6354
Practice Address - Street 1:130 S SUNNYVALE AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6249
Practice Address - Country:US
Practice Address - Phone:408-736-3802
Practice Address - Fax:408-736-6354
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12826T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist