Healthcare Provider Details

I. General information

NPI: 1376673889
Provider Name (Legal Business Name): STEVEN LEE ARNQUIST O. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 S SANDERSON AVE
HEMET CA
92545-9046
US

IV. Provider business mailing address

5324 RENAISSANCE AVE
SAN DIEGO CA
92122-5632
US

V. Phone/Fax

Practice location:
  • Phone: 951-766-1146
  • Fax: 951-766-7156
Mailing address:
  • Phone: 951-766-1146
  • Fax: 951-766-7156

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number6858T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: