Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Larry E Waggoner O D Prof Corp

Organization Optometrist · NPI 1336449388

Larry E Waggoner O D Prof Corp is an Optometrist in Lake Isabella, California. Licensed in California. Registered with an NPI since 2010.

Licensed in
CA
In the registry since
2010
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

12134 Mount Mesa Rd
Lake Isabella, CA 93240-9690
Phone: (760) 379-3602
Fax: (760) 379-2232
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 6133 (CA)

Record details

NPI number1336449388
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Larry Waggoner — Owner/Optometrist · (760) 379-3602
NPI enumeratedOctober 25, 2010
Last updated in NPPESNovember 22, 2010
Mailing address12134 Mount Mesa Rd, Lake Isabella, CA 93240-9690

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