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General NPI Number Information
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NPI Number | 1063667293
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Entity Type | Organization
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Legal Business Name | YUMA EYE SURGERY CENTER
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Dates
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Enumeration Date | 12/02/2008
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Last Update Date | 12/02/2008
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Provider Practice Location Address
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Address Line | 1375 W 16TH ST SUITE B
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City | YUMA
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State | AZ
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Zip | 85364-4497
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Country | US
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Telephone | 928-782-1980
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Fax |
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Provider Business Mailing Address
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Address Line | 1375 W 16TH ST SUITE B
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City | YUMA
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State | AZ
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Zip | 85364-4497
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Country | US
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Telephone | 928-782-1980
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Fax |
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Authorized Official
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Title or Position | OWNER / MEDICAL DIRECTOR
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Name | DR. PATRICK AIELLO
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Credential | MD
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Telephone | 928-782-1980
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | NOT APPLICABLE
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License Number State | AZ
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