Provider Demographics
NPI:1780751206
Name:INOUYE, FRANKLIN BRADFORD (OD)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:BRADFORD
Last Name:INOUYE
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 1:15923 BEAR VALLEY RD
Mailing Address - Street 2:SUITE B-100
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-1750
Mailing Address - Country:US
Mailing Address - Phone:760-949-6363
Mailing Address - Fax:760-949-9249
Practice Address - Street 1:15923 BEAR VALLEY RD
Practice Address - Street 2:SUITE B-100
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-1750
Practice Address - Country:US
Practice Address - Phone:760-949-6363
Practice Address - Fax:760-949-9249
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2009-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA10068T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0100681Medicaid