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NPI 1295029072

IndividualActive

James Licata, LDO

NPI 1295029072 · Optician · Mesa, AZ

Provider details

NPI number: 1295029072
Entity type: Individual
Primary specialty: OpticianEye and Vision Services Providers
Credential: LDO
Sex: Male
Sole proprietor: No
License: 748 (AZ)

Practice location

2048 E Baseline Rd # C-6

Mesa, AZ 85204-6969

Phone: (480) 632-5075

Fax: (480) 507-0836

More AZ providers

Mailing address

2048 E Baseline Rd # C-6

Mesa, AZ 85204-6969

Registry dates

Enumerated: 2011-06-08
Last updated: 2011-06-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

James Licata, LDO — NPI 1295029072, Mesa, AZ | NPI Central