Organization
ADVANCED LASER & EYE CENTER OF AZ PC
Active
Other names
ALECA Optical
Organization subpart
No
Provider details
NPI number
Authorized official
KIANOUSH KIAN MD (OWNER)
(480) 632-2020
Entity
Organization
Contact information
Practice address
4920 S ALMA SCHOOL RD, SUITE 3, SUN LAKES, AZ 85248-5547
(480) 632-2020
(480) 632-2121
Mailing address
3303 E BASELINE RD, #104, GILBERT, AZ 85234-2739
(480) 632-2020
(480) 632-2121
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
22618
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
172809
—
AZ
01
—
AZ0805550
BCBS
AZ
Enumeration date
12/20/2006
Last updated
05/28/2010
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