Provider Demographics
NPI:1821296732
Name:HURLEY, HENRY F (OPTICIAN ABO CERTIFI)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:F
Last Name:HURLEY
Suffix:
Gender:M
Credentials:OPTICIAN ABO CERTIFI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:914 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CARPINTERIA
Mailing Address - State:CA
Mailing Address - Zip Code:93013-2045
Mailing Address - Country:US
Mailing Address - Phone:805-684-7373
Mailing Address - Fax:
Practice Address - Street 1:914 LINDEN AVE
Practice Address - Street 2:
Practice Address - City:CARPINTERIA
Practice Address - State:CA
Practice Address - Zip Code:93013-2045
Practice Address - Country:US
Practice Address - Phone:805-684-7373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18417156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3715190001Medicare ID - Type Unspecified