Healthcare Provider Details

I. General information

NPI: 1720006083
Provider Name (Legal Business Name): JENNIFER AMANEH CURRIE OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER FARZAD

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

415 N CRESCENT DR STE 225
BEVERLY HILLS CA
90210-6809
US

IV. Provider business mailing address

415 N CRESCENT DR STE 225
BEVERLY HILLS CA
90210-6809
US

V. Phone/Fax

Practice location:
  • Phone: 310-247-8282
  • Fax: 310-247-1418
Mailing address:
  • Phone: 310-247-8282
  • Fax: 310-247-1418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13006
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT 13006
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: