MEDICARE: ALETA DOROUDIAN O.D.

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
1	152W00000X	Optometrist	911	AZ
2	152W00000X	Optometrist	OPT-000911	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497748206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALETA DOROUDIAN O.D.

Provider Business Mailing Address
First Line	:	YUMA VISION CENTER
Second Line	:	2750 S. PACIFIC AVE SUITE D
City	:	YUMA
State	:	AZ
Zip	:	85365
Country	:	US
Telephone Number	:	520-670-3909
Fax Number	:	520-884-9287

Provider Business Practice Location Address
First Line	:	YUMA VISION CENTER
Second Line	:	2750 S. PACIFIC AVE. SUITE D
City	:	YUMA
State	:	AZ
Zip	:	85365
Country	:	US
Telephone Number	:	928-782-7557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/26/2005
Last Update Date	:	03/06/2022

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