Provider Demographics
NPI:1508179706
Name:DELA CRUZ, EMMANUEL II (OD)
Entity Type:Individual
Prefix:DR
First Name:EMMANUEL
Middle Name:
Last Name:DELA CRUZ
Suffix:II
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 1:43955 S MORAY ST
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-5942
Mailing Address - Country:US
Mailing Address - Phone:408-360-9312
Mailing Address - Fax:
Practice Address - Street 1:1898 W EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-2356
Practice Address - Country:US
Practice Address - Phone:650-961-2926
Practice Address - Fax:650-961-2890
Is Sole Proprietor?:No
Enumeration Date:2010-07-16
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13964152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist