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NPI Code Detail

MEDICARE: GARRETT H. ARIZALA, O.D., PROF. CORP.

MEDICARE: GARRETT H. ARIZALA, O.D., PROF. CORP.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist298NV

General Provider Information

NPI Number : 1093947020
Entity Type Code : Organization
Provider Name (Legal Business Name) : GARRETT H. ARIZALA, O.D., PROF. CORP.
Provider Business Mailing Address
First Line : 3717 JULIUS CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89129-5519
Country : US
Telephone Number : 702-307-0828
Fax Number :
Provider Business Practice Location Address
First Line : 1910 E SERENE AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89123-3227
Country : US
Telephone Number : 702-307-0828
Fax Number :
Authorized Official
Title or Position : OWNER
Name : GARRETT ARIZALA
Credential : O.D.
Telephone Number : 702-307-0828
Provider Enumeration Date : 08/08/2009
Last Update Date : 08/08/2009

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