Provider Demographics
NPI:1548376528
Name:MCLAURIN-GIAMPICCOLO PARTNERSHIP
Entity type:Organization
Organization Name:MCLAURIN-GIAMPICCOLO PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:MCLAURIN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-362-6552
Mailing Address - Street 1:27001 MOULTON PKWY
Mailing Address - Street 2:SUITE A100
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-3600
Mailing Address - Country:US
Mailing Address - Phone:949-362-6552
Mailing Address - Fax:949-362-6566
Practice Address - Street 1:27001 MOULTON PKWY
Practice Address - Street 2:SUITE A100
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-3600
Practice Address - Country:US
Practice Address - Phone:949-362-6552
Practice Address - Fax:949-362-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWY1641DMedicare ID - Type Unspecified