Provider Demographics
NPI:1578920310
Name:SYLVIA ARCOS, OD A PROFESSIONAL CORP.
Entity Type:Organization
Organization Name:SYLVIA ARCOS, OD A PROFESSIONAL CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SYLVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:ARCOS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:562-222-1822
Mailing Address - Street 1:8308 ROSEMEAD BLVD
Mailing Address - Street 2:
Mailing Address - City:PICO RIVERA
Mailing Address - State:CA
Mailing Address - Zip Code:90660-5111
Mailing Address - Country:US
Mailing Address - Phone:562-222-1822
Mailing Address - Fax:
Practice Address - Street 1:8308 ROSEMEAD BLVD
Practice Address - Street 2:
Practice Address - City:PICO RIVERA
Practice Address - State:CA
Practice Address - Zip Code:90660-5111
Practice Address - Country:US
Practice Address - Phone:562-222-1822
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SYLVIA ARCOS, OD A PROFESSIONAL CORP.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-01-25
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10281T305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASDO102810Medicaid
CAU55047Medicare UPIN