Provider Demographics
NPI:1407916992
Name:RASW, PC
Entity Type:Organization
Organization Name:RASW, PC
Other - Org Name:RETINA ASSOCIATES SOUTHWEST, P.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:G
Authorized Official - Last Name:JAVID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-886-2597
Mailing Address - Street 1:6561 E CARONDELET DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85710-2156
Mailing Address - Country:US
Mailing Address - Phone:520-886-2597
Mailing Address - Fax:520-886-6639
Practice Address - Street 1:6561 E CARONDELET DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-2156
Practice Address - Country:US
Practice Address - Phone:520-886-2597
Practice Address - Fax:520-886-6639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ517401Medicaid
AZ517401Medicaid