Provider Demographics
NPI:1659425635
Name:GISS, WARREN H (OD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:H
Last Name:GISS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7251 BRIARCLIFF CIRCLE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-1401
Mailing Address - Country:US
Mailing Address - Phone:805-644-3458
Mailing Address - Fax:
Practice Address - Street 1:200 S WELLS RD
Practice Address - Street 2:CLINICAS DEL CAMINO REAL INC SUITE 250
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93004
Practice Address - Country:US
Practice Address - Phone:805-659-1740
Practice Address - Fax:805-659-9959
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA04163T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist