Provider Demographics
NPI:1548456585
Name:LYON, WILLIAM V (RDO RCLD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:V
Last Name:LYON
Suffix:
Gender:M
Credentials:RDO RCLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3000 W MACARTHUR BLVD STE 413
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-6941
Mailing Address - Country:US
Mailing Address - Phone:714-979-9747
Mailing Address - Fax:714-979-9749
Practice Address - Street 1:3000 W MACARTHUR BLVD STE 413
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-6941
Practice Address - Country:US
Practice Address - Phone:714-979-9747
Practice Address - Fax:714-979-9749
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-24
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACL301156FC0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FC0801XEye and Vision Services ProvidersTechnician/TechnologistContact Lens Fitter