Provider Demographics
NPI:1548540867
Name:ARDIS, JAMES JOSEPH (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:ARDIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 PANAMA LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93313-3509
Mailing Address - Country:US
Mailing Address - Phone:866-707-6664
Mailing Address - Fax:
Practice Address - Street 1:4600 PANAMA LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93313-3509
Practice Address - Country:US
Practice Address - Phone:866-707-6664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-17
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14193 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist