Organization
ADVANCED LASER &EYE CENTER OF ARIZONA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIANOUSH KIAN MD (OWNER PRESIDENT)
(480) 632-2020
Entity
Organization
Contact information
Practice address
3303 E BASELINE RD, #104, GILBERT, AZ 85234-2739
(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
01
—
1009192
AETNA INS CO
AZ
01
—
33209
EVERCARE
—
01
—
3Z3345
HEALTHNET
AZ
Enumeration date
05/19/2006
Last updated
01/23/2013
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