Provider Demographics
NPI:1356505960
Name:GILBUENA, JOSEPH DANIEL (OD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:DANIEL
Last Name:GILBUENA
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 1:1425 S ALMA SCHOOL RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-2000
Mailing Address - Country:US
Mailing Address - Phone:480-615-9010
Mailing Address - Fax:
Practice Address - Street 1:1010 EAST MCDOWELL RD
Practice Address - Street 2:STE 301
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2609
Practice Address - Country:US
Practice Address - Phone:602-222-2234
Practice Address - Fax:866-985-7247
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-12
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHT3003152W00000X
OR3264ATI152W00000X
AZ2039152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist