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General NPI Number Information
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NPI Number | 1518049477
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Entity Type | Organization
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Legal Business Name | PINNACLE PEAK EYE CARE AND OPTICAL PC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7420 E PINNACLE PEAK RD SUITE 122
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3625
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Country | US
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Telephone | 480-473-0079
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Fax | 480-473-3357
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Provider Business Mailing Address
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Address Line | 7420 E PINNACLE PEAK RD SUITE 122
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City | SCOTTSDALE
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State | AZ
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Zip | 85255-3625
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Country | US
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Telephone | 480-473-0079
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Fax | 480-473-3357
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREG A STIPEK
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Credential | O.D.
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Telephone | 480-473-0079
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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 | 820
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License Number State | AZ
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