Provider Demographics
NPI:1932384625
Name:ARROYO VISTA OPTOMETRY, P.C.
Entity Type:Organization
Organization Name:ARROYO VISTA OPTOMETRY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:DECUIR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:805-530-3937
Mailing Address - Street 1:252 W LOS ANGELES AVE STE G
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-1890
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:252 W LOS ANGELES AVE STE G
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-1890
Practice Address - Country:US
Practice Address - Phone:805-530-3937
Practice Address - Fax:805-530-3933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-01
Last Update Date:2008-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11872T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty