Healthcare Provider Details

I. General information

NPI: 1104884931
Provider Name (Legal Business Name): CELESTE ARROYO PAZ O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 04/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 MOWRY AVE SUITE #106
FREMONT CA
94538-1509
US

IV. Provider business mailing address

3100 MOWRY AVE SUITE #106
FREMONT CA
94538-1509
US

V. Phone/Fax

Practice location:
  • Phone: 510-713-2040
  • Fax: 510-713-7737
Mailing address:
  • Phone: 510-713-2040
  • Fax: 510-713-7737

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License NumberOPT 7752 TPL
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: