MEDICARE: AMBER LOUISE BELAUSTEGUI 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	626	NV

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	:	1689830598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMBER LOUISE BELAUSTEGUI O.D.

Provider Business Mailing Address
First Line	:	3620 MAYBERRY DR STE 103
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-2131
Country	:	US
Telephone Number	:	775-525-3377
Fax Number	:	775-549-6095

Provider Business Practice Location Address
First Line	:	3620 MAYBERRY DR STE 103
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89509-2131
Country	:	US
Telephone Number	:	775-525-3377
Fax Number	:	775-549-6095

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

Provider Enumeration Date	:	07/30/2008
Last Update Date	:	12/06/2023

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