Provider Demographics
NPI:1629144126
Name:CUADROS, JORGE ANTHONY (OD, PHD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:ANTHONY
Last Name:CUADROS
Suffix:
Gender:M
Credentials:OD, PHD
Other - Prefix:DR
Other - First Name:JORGE
Other - Middle Name:ANTHONY
Other - Last Name:CUADROS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD, PHD
Mailing Address - Street 1:678 E. SANTA CLARA ST.
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112
Mailing Address - Country:US
Mailing Address - Phone:408-293-2020
Mailing Address - Fax:
Practice Address - Street 1:678 E. SANTA CLARA ST.
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112
Practice Address - Country:US
Practice Address - Phone:408-293-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6891T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist