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General NPI Number Information
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NPI Number | 1275999385
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Entity Type | Organization
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Legal Business Name | CAMINO EYE CLINIC, LLC
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Dates
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Enumeration Date | 01/05/2016
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Last Update Date | 01/05/2016
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Provider Practice Location Address
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Address Line | 13629 W CAMINO DEL SOL STE 202
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City | SUN CITY WEST
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State | AZ
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Zip | 85375-1400
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Country | US
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Telephone | 623-584-3610
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Fax | 623-933-2952
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Provider Business Mailing Address
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Address Line | 13340 N 94TH DR
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City | PEORIA
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State | AZ
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Zip | 85381-4236
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Country | US
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Telephone | 623-977-8341
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | CHRYSANNE RINDERKNECHT
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Credential | M.D.
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Telephone | 623-977-8341
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 20524190-C
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License Number State | AZ
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