Provider Demographics
NPI:1972243640
Name:OPTIMAL MEDICAL CARE INC
Entity type:Organization
Organization Name:OPTIMAL MEDICAL CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:NOURLIE
Authorized Official - Middle Name:IBUYAT
Authorized Official - Last Name:CARLOS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-859-6705
Mailing Address - Street 1:3320 W GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-6531
Mailing Address - Country:US
Mailing Address - Phone:559-859-6705
Mailing Address - Fax:
Practice Address - Street 1:1860 S CENTRAL ST STE B
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4497
Practice Address - Country:US
Practice Address - Phone:559-859-6705
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-31
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty