Provider Demographics
NPI:1710977574
Name:ALMARAZ, JAMES WILLIAM (O D)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:WILLIAM
Last Name:ALMARAZ
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2820
Mailing Address - Street 2:
Mailing Address - City:BIG BEAR LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:92315-2820
Mailing Address - Country:US
Mailing Address - Phone:909-866-5701
Mailing Address - Fax:909-866-2155
Practice Address - Street 1:41340 BIG BEAR BLVD
Practice Address - Street 2:
Practice Address - City:BIG BEAR LAKE
Practice Address - State:CA
Practice Address - Zip Code:92315-2820
Practice Address - Country:US
Practice Address - Phone:909-866-5701
Practice Address - Fax:909-866-2155
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2015-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6588T152W00000X
332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0065880Medicaid
CASD0065880Medicare PIN
CAT10366Medicare UPIN