Bella Vista Optical Pllc

NPI #1154607943 in Glendale, Arizona

Provider Information

NPI Number: 1154607943
Entity Type: Organization
Organization Name: Bella Vista Optical Pllc
Primary Specialty: Optometrist
Enumeration Date: Oct 25, 2011
Last Updated: Apr 14, 2021

Practice Location

Address: 7122 N 59TH AVE FL 1
City: Glendale
State: Arizona
ZIP Code: 85301-2436
Phone: (623) 931-1043

Authorized Official

Name: DR. SELVIN GNANAKKAN, O.D.
Title: MEDICAL DIRECTOR
Phone: (602) 770-9300

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Health Service — Health Service	261QH0100X
Optometrist	152W00000X	Primary

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