Provider Demographics
NPI:1275999385
Name:CAMINO EYE CLINIC, LLC
Entity Type:Organization
Organization Name:CAMINO EYE CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHRYSANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:RINDERKNECHT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:623-977-8341
Mailing Address - Street 1:13340 N 94TH DR
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4236
Mailing Address - Country:US
Mailing Address - Phone:623-977-8341
Mailing Address - Fax:
Practice Address - Street 1:13629 W CAMINO DEL SOL STE 202
Practice Address - Street 2:
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-1400
Practice Address - Country:US
Practice Address - Phone:623-584-3610
Practice Address - Fax:623-933-2952
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLAZA DEL RIO EYE CLINIC, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ20524190-C332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier