Provider Demographics
NPI:1922019389
Name:PAZORNIK, ARTHUR (OD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:
Last Name:PAZORNIK
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 1:75 REMITTANCE DR DEPT 6008
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-6008
Mailing Address - Country:US
Mailing Address - Phone:562-282-1419
Mailing Address - Fax:562-920-4642
Practice Address - Street 1:2220 CLARK AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-2521
Practice Address - Country:US
Practice Address - Phone:562-597-4181
Practice Address - Fax:562-597-7083
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT4978152W00000X
CA4978152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0049780Medicaid
CA410046775OtherRAILROAD MEDICARE
CA410046775OtherMEDICARE RAILROAD
CA00OPT49780OtherBLUE SHIELD
CASA0049780Medicaid
CAU38516Medicare UPIN
CA410046775OtherRAILROAD MEDICARE