MEDICARE: DR. MONICA ELAINE DIAMOS 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	OD831	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1528046240	OTHER	AZ	IND NPI

General Provider Information

NPI Number	:	1528046240
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MONICA ELAINE DIAMOS O.D.

Provider Business Mailing Address
First Line	:	3801 N CAMPBELL AVE
Second Line	:	SUITE E
City	:	TUCSON
State	:	AZ
Zip	:	85719-1448
Country	:	US
Telephone Number	:	520-327-2400
Fax Number	:	520-327-2233

Provider Business Practice Location Address
First Line	:	3801 N CAMPBELL AVE
Second Line	:	SUITE E
City	:	TUCSON
State	:	AZ
Zip	:	85719-1448
Country	:	US
Telephone Number	:	520-327-2400
Fax Number	:	520-327-2233

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

Provider Enumeration Date	:	01/03/2006
Last Update Date	:	05/15/2013

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