MEDICARE: HELLAN EYECARE, LLC

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1427523653
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELLAN EYECARE, LLC

Provider Business Mailing Address
First Line	:	18277 W LA MIRADA DR
Second Line	:
City	:	GOODYEAR
State	:	AZ
Zip	:	85338-5240
Country	:	US
Telephone Number	:	954-296-4194
Fax Number	:

Provider Business Practice Location Address
First Line	:	13055 W RANCHO SANTA FE BLVD
Second Line	:
City	:	AVONDALE
State	:	AZ
Zip	:	85392-1700
Country	:	US
Telephone Number	:	623-535-4215
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	ASINECH HELLAN
Credential	:	OD
Telephone Number	:	954-296-4194

Provider Enumeration Date	:	10/03/2018
Last Update Date	:	10/03/2018

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Directions to “HELLAN EYECARE, LLC ” Practice Location

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