Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2085 | AZ |
NPI | 1003286311 |
---|---|
Provider Name | Dr. Margarita Alicia Coca |
First Address | Glendale, AZ 85306-1532 |
Second Address | Glendale, AZ 85308-8616 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2015 |
Last Update Date | 29/09/2015 |