Provider Demographics
NPI:1316145055
Name:MURAOKA, CRYSTAL FUKUMI (OD)
Entity type:Individual
Prefix:DR
First Name:CRYSTAL
Middle Name:FUKUMI
Last Name:MURAOKA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:979 MODJESKA CIR
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3909
Mailing Address - Country:US
Mailing Address - Phone:714-478-0652
Mailing Address - Fax:
Practice Address - Street 1:2049 BREA MALL
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5756
Practice Address - Country:US
Practice Address - Phone:714-990-9311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13267152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist