Provider Demographics
NPI:1346328531
Name:ARABO, KUSAY ISAM (OD)
Entity Type:Individual
Prefix:DR
First Name:KUSAY
Middle Name:ISAM
Last Name:ARABO
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8235 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-3820
Mailing Address - Country:US
Mailing Address - Phone:619-461-4913
Mailing Address - Fax:619-465-5070
Practice Address - Street 1:8235 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-3820
Practice Address - Country:US
Practice Address - Phone:619-461-4913
Practice Address - Fax:619-465-5070
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2021-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12543152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOP12543Medicare PIN