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General NPI Number Information
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NPI Number | 1699457176
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Entity Type | Organization
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Legal Business Name | OPTIMAL CARE AND WELLNESS LLC
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Dates
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Enumeration Date | 08/03/2023
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 74 W 2ND ST
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City | YUMA
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State | AZ
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Zip | 85364-2250
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Country | US
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Telephone | 928-257-1223
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Fax | 928-267-4091
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Provider Business Mailing Address
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Address Line | 74 W 2ND ST
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City | YUMA
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State | AZ
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Zip | 85364-2250
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Country | US
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Telephone | 928-287-0033
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Fax |
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Authorized Official
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Title or Position | NP
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Name | YESENIA GIANAROS
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Credential | NP
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Telephone | 928-257-1223
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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