Provider Demographics
NPI:1811948805
Name:RHAZI, MARIA L (OD)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:L
Last Name:RHAZI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 WAGONEER RD
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:UT
Mailing Address - Zip Code:84043-8164
Mailing Address - Country:US
Mailing Address - Phone:801-225-4700
Mailing Address - Fax:
Practice Address - Street 1:125 S STATE ST
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-5419
Practice Address - Country:US
Practice Address - Phone:801-225-4700
Practice Address - Fax:801-225-4700
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT4948123-9934152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000090566Medicare ID - Type Unspecified
UTU66830Medicare UPIN