Healthcare Provider Details

I. General information

NPI: 1295973931
Provider Name (Legal Business Name): SONORAN DESERT VISION CENTER, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 02/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10255 N 32ND ST
PHOENIX AZ
85028-3851
US

IV. Provider business mailing address

10255 N 32ND ST
PHOENIX AZ
85028-3851
US

V. Phone/Fax

Practice location:
  • Phone: 602-957-2350
  • Fax: 602-254-3474
Mailing address:
  • Phone: 602-957-2350
  • Fax: 602-254-3474

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS0132X
TaxonomyOphthalmologic Surgery Clinic/Center
License Number13944
License Number StateAZ

VIII. Authorized Official

Name: DR. TODD ALLEN LEFKOWITZ
Title or Position: PRESIDENT
Credential: M.D.
Phone: 602-957-2350