Provider Demographics
NPI:1639480510
Name:SLOAN, JAMES ROBERT (OD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ROBERT
Last Name:SLOAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:13321 MOORPARK ST
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3917
Mailing Address - Country:US
Mailing Address - Phone:818-501-5565
Mailing Address - Fax:818-784-2894
Practice Address - Street 1:13321 MOORPARK ST
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423
Practice Address - Country:US
Practice Address - Phone:818-501-5565
Practice Address - Fax:818-784-2894
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14555TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist