Custom Vision Care Associates PA

NPI #1013212133 in Nampa, Idaho

Provider Information

NPI Number: 1013212133
Entity Type: Organization
Organization Name: Custom Vision Care Associates PA
Primary Specialty: Ophthalmology
Enumeration Date: Jan 20, 2011
Last Updated: Jan 20, 2011

Practice Location

Address: 1615 12TH AVE RD STE B
City: Nampa
State: Idaho
ZIP Code: 83686-6184
Phone: (208) 498-1700

Authorized Official

Name: JORGE A MARTINEZ, M.D.
Title: PHYSICIAN OWNER
Phone: (208) 498-1700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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