Basic Information
Provider Information
NPI: 1760677512
EntityType: 2
ReplacementNPI:  
OrganizationName: ROBERT J. JOYCE O.D.
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
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Mailing Information
Address1: 32245 MISSION TRL
Address2: STE. D4
City: LAKE ELSINORE
State: CA
PostalCode: 925304528
CountryCode: US
TelephoneNumber: 9516741561
FaxNumber: 9516745300
Practice Location
Address1: 32245 MISSION TRL
Address2: STE. D4
City: LAKE ELSINORE
State: CA
PostalCode: 925304528
CountryCode: US
TelephoneNumber: 9516741561
FaxNumber: 9516745300
Other Information
ProviderEnumerationDate: 09/13/2007
LastUpdateDate: 07/11/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: JOYCE
AuthorizedOfficialFirstName: ROBERT
AuthorizedOfficialMiddleName: J.
AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 9516741561
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential: O.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X11833CAY193400000X SINGLE SPECIALTY GROUPEye and Vision Services ProvidersOptometrist 

No ID Information.


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