Healthcare Provider Details

I. General information

NPI: 1114841640
Provider Name (Legal Business Name): JEWEL'S EYECARE, PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 S VICTORY BLVD
BURBANK CA
91502-2427
US

IV. Provider business mailing address

1031 W KENNETH RD APT C
GLENDALE CA
91202-1480
US

V. Phone/Fax

Practice location:
  • Phone: 818-842-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JULLIETTE JEWEL KESTENIAN
Title or Position: OPTOMETRIST
Credential: OD
Phone: 818-484-6284