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General NPI Number Information
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NPI Number | 1275752214
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Entity Type | Organization
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Legal Business Name | GATESH OPTICIANS
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7113 E 1ST AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4305
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Country | US
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Telephone | 480-947-2171
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Fax | 480-990-1012
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Provider Business Mailing Address
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Address Line | 7113 E 1ST AVE
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City | SCOTTSDALE
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State | AZ
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Zip | 85251-4305
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Country | US
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Telephone | 480-947-2171
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Fax | 480-990-1012
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Authorized Official
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Title or Position | OWNER
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Name | MR. GEORGE GATESH
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Credential |
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Telephone | 480-947-2171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 07081073U
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License Number State | AZ
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