Provider Demographics
NPI:1013330745
Name:MOORE, ANNA LO (OD)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:LO
Last Name:MOORE
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Gender:F
Credentials:OD
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Mailing Address - Street 1:101 N CORONADO DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:SIERRA VISTA
Mailing Address - State:AZ
Mailing Address - Zip Code:85635-6358
Mailing Address - Country:US
Mailing Address - Phone:520-459-1529
Mailing Address - Fax:520-459-3654
Practice Address - Street 1:2580 N LITCHFIELD RD
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2049
Practice Address - Country:US
Practice Address - Phone:623-932-2020
Practice Address - Fax:623-932-2668
Is Sole Proprietor?:No
Enumeration Date:2014-01-31
Last Update Date:2014-04-01
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Provider Licenses
StateLicense IDTaxonomies
AZ1922152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist