Provider Demographics
NPI:1568565968
Name:PILON, ANDREW FRANCIS (OD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:FRANCIS
Last Name:PILON
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 1:1200 N TUSTIN AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3508
Mailing Address - Country:US
Mailing Address - Phone:714-647-1200
Mailing Address - Fax:714-647-0200
Practice Address - Street 1:1200 N. TUSTIN AVE.
Practice Address - Street 2:SUITE 130
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3501
Practice Address - Country:US
Practice Address - Phone:714-647-1200
Practice Address - Fax:714-647-1200
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12540TPA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U96868Medicare UPIN
CAWOP12540AMedicare ID - Type Unspecified