Provider Demographics
NPI:1689973653
Name:ARROYO VISION CENTER
Entity type:Organization
Organization Name:ARROYO VISION CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:KHALED
Authorized Official - Middle Name:A
Authorized Official - Last Name:TAWANSY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-257-3937
Mailing Address - Street 1:7447 N FIGUEROA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-1718
Mailing Address - Country:US
Mailing Address - Phone:323-257-3937
Mailing Address - Fax:877-579-4558
Practice Address - Street 1:7447 N FIGUEROA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1718
Practice Address - Country:US
Practice Address - Phone:323-256-3937
Practice Address - Fax:323-257-3200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-16
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG767620207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty