Jack M. Elizares Optometric Corporation

NPI #1164932976 in Clearlake, California

Provider Information

NPI Number: 1164932976
Entity Type: Organization
Organization Name: Jack M. Elizares Optometric Corporation
Primary Specialty: Optometrist
Enumeration Date: Oct 6, 2017
Last Updated: Oct 6, 2017

Practice Location

Address: 3610 OLD HWY 53
City: Clearlake
State: California
ZIP Code: 95422-9543
Phone: (707) 994-8641

Authorized Official

Name: JACK M. ELIZARES, OD
Title: CEO, CFO
Phone: (707) 994-8641

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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