Healthcare Provider Details
I. General information
NPI: 1144075649
Provider Name (Legal Business Name): RNS OCULO PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/19/2024
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10910 N TATUM BLVD STE B-100
PHOENIX AZ
85028-3080
US
IV. Provider business mailing address
10910 N TATUM BLVD STE B-100
PHOENIX AZ
85028-3080
US
V. Phone/Fax
- Phone: 480-291-6895
- Fax: 480-948-3750
- Phone: 480-291-6895
- Fax: 480-948-3750
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207WX0200X |
| Taxonomy | Ophthalmic Plastic and Reconstructive Surgery Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208200000X |
| Taxonomy | Plastic Surgery Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RAMYAR
TORABI
Title or Position: OWNER
Credential: MD
Phone: 480-291-6895