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General NPI Number Information
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NPI Number | 1710732839
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Entity Type | Organization
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Legal Business Name | CAVE CREEK EYE LLC
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Dates
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Enumeration Date | 04/22/2024
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Last Update Date | 04/22/2024
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Provider Practice Location Address
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Address Line | 7100 E CAVE CREEK RD STE 141
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City | CAVE CREEK
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State | AZ
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Zip | 85331-4311
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Country | US
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Telephone | 623-302-5888
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 6292
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City | SCOTTSDALE
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State | AZ
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Zip | 85261-6292
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Country | US
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Telephone | 480-436-3445
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE MEMBER
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Name | DR. SHAWN GIESE
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Credential | OD
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Telephone | 480-436-3445
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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 |
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License Number State |
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