Provider Demographics
NPI:1104884931
Name:PAZ, CELESTE ARROYO (OD)
Entity type:Individual
Prefix:DR
First Name:CELESTE
Middle Name:ARROYO
Last Name:PAZ
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3100 MOWRY AVE
Mailing Address - Street 2:SUITE #106
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1509
Mailing Address - Country:US
Mailing Address - Phone:510-713-2040
Mailing Address - Fax:510-713-7737
Practice Address - Street 1:3100 MOWRY AVE
Practice Address - Street 2:SUITE #106
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1509
Practice Address - Country:US
Practice Address - Phone:510-713-2040
Practice Address - Fax:510-713-7737
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 7752 TPL152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0077520Medicaid
CAT10592Medicare UPIN
CASD0077520Medicaid