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General NPI Number Information
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NPI Number | 1053437640
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Entity Type | Organization
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Legal Business Name | ALEJANDRO M. ARREDONDO O.D. OPT. CORP.
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 2675 SATURN AVE
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City | HUNTINGTON PARK
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State | CA
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Zip | 90255-4142
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Country | US
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Telephone | 323-581-0117
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Fax | 323-562-4445
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Provider Business Mailing Address
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Address Line | 4349 SLAUSON AVE SUITE A
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City | MAYWOOD
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State | CA
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Zip | 90270-2837
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Country | US
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Telephone | 323-581-0117
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Fax | 323-562-4445
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALEJANDRO MIGUEL ARREDONDO
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Credential | O.D.
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Telephone | 323-583-7900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8658T
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License Number State | CA
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