Mark a. Jury Optometric Professional Corporation

Primary specialty

OptometristTaxonomy code 152W00000X

License

9583 T Issued in CA

Legal business name

MARK A. JURY OPTOMETRIC PROFESSIONAL CORPORATION

Practice address

23905 Clinton Keith Road, Suite 115
Wildomar, CA 92595-7899

Phone

(951) 304-9733

Fax

(951) 304-9734

NPI assigned

Oct 24, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mark Alan Jury, O.D.

Title

Optometrist

Phone

(951) 304-9733

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Connor, O.D.

  • Optometrist
  • Wildomar, CA
  • NPI 1063968980
  NPD (past)
• Evelyn Lee, OD

  • Optometrist
  • Corona, CA
  • NPI 1073042941
  NPD (past)
• Matthew Sean Love, O.D.

  • Optometrist
  • Temecula, CA
  • NPI 1407238199
  NPD (past)
• Brian Lemoyne Parker, O.D.

  • Optometrist
  • Wildomar, CA
  • NPI 1558591545
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316390400000",
    "number": "1033293592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23905 CLINTON KEITH ROAD, SUITE 115",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957899",
            "telephone_number": "951-304-9733",
            "fax_number": "951-304-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23905 CLINTON KEITH ROAD, SUITE 115",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957899",
            "telephone_number": "951-304-9733",
            "fax_number": "951-304-9734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. JURY OPTOMETRIC PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-24",
        "last_updated": "2011-09-19",
        "status": "A",
        "authorized_official_last_name": "JURY",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "951-304-9733",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "CA",
            "license": "9583 T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0095830",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carolyn Mandio, BCBA
• Lauren Manzano
• Marcella Bonnici, M.D. Professional Corporation
• Hide Mariscal
• Mark a Jury, OD a Optometric Professional Corporation
• Juli Markham
• Kelley Jeniece Marlowe
• Cithlaly Marquez Albarran
• Michele L Marquez, PHARMACY TECH
• Alicia Marie Marron

• Optometrist in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.