Basic Information
| Provider Information | |||||||||
| NPI: | 1003286311 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COCA | ||||||||
| FirstName: | MARGARITA | ||||||||
| MiddleName: | ALICIA | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 16630 N 43RD AVE APT 130 | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853061532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5592868040 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7700 W ARROWHEAD TOWNE CTR | ||||||||
| Address2: | |||||||||
| City: | GLENDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 853088616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6234862020 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/29/2015 | ||||||||
| LastUpdateDate: | 09/29/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2085 | AZ | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.