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General NPI Number Information
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NPI Number | 1932384625
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Entity Type | Organization
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Legal Business Name | ARROYO VISTA OPTOMETRY, P.C.
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Dates
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Enumeration Date | 01/01/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 252 W LOS ANGELES AVE STE G
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City | MOORPARK
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State | CA
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Zip | 93021-1890
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Country | US
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Telephone | 805-530-3937
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Fax | 805-530-3933
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Provider Business Mailing Address
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Address Line | 252 W LOS ANGELES AVE STE G
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City | MOORPARK
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State | CA
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Zip | 93021-1890
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER / OPTOMETRIST
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Name | DR. BRIAN ALEXANDER DECUIR
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Credential | O.D
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Telephone | 805-530-3937
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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 | 11872T
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License Number State | CA
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