Provider Demographics
NPI:1295885804
Name:HIGA, BRIAN NORIO (OD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:NORIO
Last Name:HIGA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 S LYON AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-3851
Mailing Address - Country:US
Mailing Address - Phone:951-929-3773
Mailing Address - Fax:
Practice Address - Street 1:220 S LYON AVE
Practice Address - Street 2:SUITE E
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-3851
Practice Address - Country:US
Practice Address - Phone:951-929-3773
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2008-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10130T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA9V12058OtherINLAND EMPIRE HEALTH PLAN
CA02121OtherMEDICAL EYE SERVICES
CASD0101300Medicaid
CA9V12058OtherINLAND EMPIRE HEALTH PLAN
CA02121OtherMEDICAL EYE SERVICES