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NPI Code Detail

MEDICARE: INVISION MEDICAL LLC

MEDICARE: INVISION MEDICAL LLC
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
1152W00000XOptometrist29AZ
2152W00000XOptometrist1103AZ
3152W00000XOptometrist1463AZ
4152W00000XOptometrist62AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11407814544OTHERAZNPI
21578520094OTHERAZNPI
31932197308OTHERAZNPI
41104882760OTHERAZNPI

General Provider Information

NPI Number : 1336175710
Entity Type Code : Organization
Provider Name (Legal Business Name) : INVISION MEDICAL LLC
Provider Business Mailing Address
First Line : 2610 E UNIVERSITY DR
Second Line :
City : MESA
State : AZ
Zip : 85213-8436
Country : US
Telephone Number : 480-892-8400
Fax Number : 480-890-3373
Provider Business Practice Location Address
First Line : 2610 E UNIVERSITY DR
Second Line :
City : MESA
State : AZ
Zip : 85213-8436
Country : US
Telephone Number : 480-892-8400
Fax Number : 480-890-3373
Authorized Official
Title or Position : PRESIDENT
Name : MR. STEVEN MICHAEL SUNDER
Credential : OPTICIAN
Telephone Number : 480-892-8400
Provider Enumeration Date : 06/25/2006
Last Update Date : 08/22/2020

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Directions to “INVISION MEDICAL LLC ” Practice Location

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