Basic Information
| Provider Information | |||||||||
| NPI: | 1821124587 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | VITAL SIGHT, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5632 E 5TH ST | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857112444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207908888 | ||||||||
| FaxNumber: | 5207901427 | ||||||||
| Practice Location | |||||||||
| Address1: | 5632 E 5TH ST | ||||||||
| Address2: | |||||||||
| City: | TUCSON | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 857112444 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5207908888 | ||||||||
| FaxNumber: | 5207901427 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/26/2007 | ||||||||
| LastUpdateDate: | 09/17/2020 | ||||||||
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| AuthorizedOfficialLastName: | RABINOWITZ | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
| AuthorizedOfficialMiddleName: | I | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF MEDICAL OFFICER/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6025084843 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 09/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | OSC 0018 | AZ | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.