Provider Demographics
NPI:1760677512
Name:ROBERT J. JOYCE O.D.
Entity Type:Organization
Organization Name:ROBERT J. JOYCE O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:JOYCE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:951-674-1561
Mailing Address - Street 1:32245 MISSION TRL
Mailing Address - Street 2:STE. D4
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92530-4528
Mailing Address - Country:US
Mailing Address - Phone:951-674-1561
Mailing Address - Fax:951-674-5300
Practice Address - Street 1:32245 MISSION TRL
Practice Address - Street 2:STE. D4
Practice Address - City:LAKE ELSINORE
Practice Address - State:CA
Practice Address - Zip Code:92530-4528
Practice Address - Country:US
Practice Address - Phone:951-674-1561
Practice Address - Fax:951-674-5300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-13
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11833152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6021080001Medicare NSC