Provider Demographics
NPI:1093882839
Name:ARCEGA, ARLENE SARROCA (OD)
Entity Type:Individual
Prefix:
First Name:ARLENE
Middle Name:SARROCA
Last Name:ARCEGA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:ARLENE
Other - Middle Name:
Other - Last Name:SARROCA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2295 S VINEYARD AVE
Mailing Address - Street 2:BLDG A
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91761-7925
Mailing Address - Country:US
Mailing Address - Phone:909-724-2180
Mailing Address - Fax:
Practice Address - Street 1:9961 SIERRA AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-6720
Practice Address - Country:US
Practice Address - Phone:909-427-3910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT12001T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist