Provider Demographics
NPI:1982751624
Name:SPALLONE, JOHN WILLIAM JR (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:WILLIAM
Last Name:SPALLONE
Suffix:JR
Gender:M
Credentials:OD
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Mailing Address - Street 1:1635 DIVISADERO ST
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3036
Mailing Address - Country:US
Mailing Address - Phone:415-833-2020
Mailing Address - Fax:415-833-2609
Practice Address - Street 1:1635 DIVISADERO ST
Practice Address - Street 2:SUITE 400A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3036
Practice Address - Country:US
Practice Address - Phone:415-833-2020
Practice Address - Fax:415-833-2609
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA07355T152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management