Provider Demographics
NPI:1669511713
Name:GIRALDI, JAMES J (OD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:J
Last Name:GIRALDI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:30313 CANWOOD ST
Mailing Address - Street 2:#24
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301
Mailing Address - Country:US
Mailing Address - Phone:818-991-3937
Mailing Address - Fax:818-991-3828
Practice Address - Street 1:30313 CANWOOD ST
Practice Address - Street 2:#24
Practice Address - City:AGOURA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91301
Practice Address - Country:US
Practice Address - Phone:818-991-3937
Practice Address - Fax:818-991-3828
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5271T152W00000X
CAOPT5271T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0P5271Medicare PIN