Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 5129 | CA |
NPI | 1326195538 |
---|---|
Provider Name | John Henry Arvizu |
First Address | Gilroy, CA 95020-7303 |
Second Address | Gilroy, CA 95020-7303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 08/07/2007 |