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General NPI Number Information
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NPI Number | 1164092276
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Entity Type | Individual
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Provider Name | ERIKA SAUCEDO OD
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Gender | Female
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Dates
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Enumeration Date | 06/30/2021
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 650 NORTH AVE NE STE 103
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City | ATLANTA
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State | GA
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Zip | 30308-2749
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Country | US
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Telephone | 470-837-2391
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Fax |
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Provider Business Mailing Address
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Address Line | 1824 DEFOOR AVE NW APT 3211
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City | ATLANTA
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State | GA
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Zip | 30318-3034
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Country | US
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Telephone | 678-642-0254
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | OPT003554
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License Number State | GA
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