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
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.