Provider Demographics
NPI:1417210493
Name:GREINER, JASON R (OD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:R
Last Name:GREINER
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 1:11502 LA CIMA DR
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-3205
Mailing Address - Country:US
Mailing Address - Phone:562-665-6939
Mailing Address - Fax:
Practice Address - Street 1:4945 YORBA RANCH RD STE E
Practice Address - Street 2:
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-2553
Practice Address - Country:US
Practice Address - Phone:714-692-2063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-24
Last Update Date:2012-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14396152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist