Basic Information
| Provider Information | |||||||||
| NPI: | 1801983473 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | UZCATEGUI | ||||||||
| FirstName: | NICOLAS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7245 E OSBORN RD STE 4 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852516443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809945012 | ||||||||
| FaxNumber: | 4809949479 | ||||||||
| Practice Location | |||||||||
| Address1: | 7245 E OSBORN RD STE 4 | ||||||||
| Address2: | |||||||||
| City: | SCOTTSDALE | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852516443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809945012 | ||||||||
| FaxNumber: | 4809949479 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 05/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 53806 | AZ | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207W00000X | 250473 | NY | N | Allopathic & Osteopathic Physicians | Ophthalmology | 207WX0200X | 250473 | NY | N | 207WX0200X | A72027 | CA | N | 207WX0200X | 53806 | AZ | N | 207W00000X | A72027 | CA | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 00A720270 | 05 | CA | MEDICAID | 247118 | 05 | AZ | MEDICAID |