Provider Demographics
NPI:1720161565
Name:YOCHEM, DONALD ARTHUR (OD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ARTHUR
Last Name:YOCHEM
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:PO BOX 1423
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-0026
Mailing Address - Country:US
Mailing Address - Phone:760-247-5842
Mailing Address - Fax:760-247-7250
Practice Address - Street 1:21825 OUTER HWY 18
Practice Address - Street 2:SUITE A
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307
Practice Address - Country:US
Practice Address - Phone:760-247-5842
Practice Address - Fax:760-247-7250
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4658T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA45911OtherSAFEGUARD
CA11059Medicaid
CASD0046581Medicaid
CA011283OtherBLOCK VISION
CA4658OtherHEALTHNET
UT17084OtherSPECTERA
OHCA4658OtherEYE MED VISION
CA38067OtherDAVIS VISION
CA3367OtherMEDICAL EYE SERVICES