Organization
PRIMARY EYE CARE CENTER OF AHWATUKEE, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DE RUBEIS OD (CEO)
(480) 706-2020
Entity
Organization
Contact information
Practice address
16515 S 40TH ST STE 111, PHOENIX, AZ 85048-0559
(480) 706-2020
Mailing address
3107 E SOUTH FORK DR, PHOENIX, AZ 85048-8753
(480) 330-5081
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
152WC0802X
Corneal and Contact Management Optometrist
—
—
152WP0200X
Pediatric Optometrist
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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