MEDICARE: DR. JOHN W ARTEAGA OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	6159TPL	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346216926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN W ARTEAGA OD

Provider Business Mailing Address
First Line	:	4041 N FRESNO ST
Second Line	:	STE 102
City	:	FRESNO
State	:	CA
Zip	:	93726-4037
Country	:	US
Telephone Number	:	559-227-7512
Fax Number	:	559-227-7574

Provider Business Practice Location Address
First Line	:	4041 N FRESNO ST
Second Line	:	STE 102
City	:	FRESNO
State	:	CA
Zip	:	93726-4037
Country	:	US
Telephone Number	:	559-227-7512
Fax Number	:	559-227-7574

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2006
Last Update Date	:	01/19/2010

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Directions to “ DR. JOHN W ARTEAGA OD” Practice Location

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