Provider Demographics
NPI:1952594863
Name:ARAMBULA, JAIME
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:ARAMBULA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 E TALLOW LN
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-7092
Mailing Address - Country:US
Mailing Address - Phone:510-684-4581
Mailing Address - Fax:
Practice Address - Street 1:3132 S BOWN WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83706-5400
Practice Address - Country:US
Practice Address - Phone:208-957-6504
Practice Address - Fax:208-629-1559
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP-100600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist