Healthcare Provider Details

I. General information

NPI: 1841108701
Provider Name (Legal Business Name): YAZDAN OPTOMETRY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

431 W VENTURA BLVD
CAMARILLO CA
93010-9122
US

IV. Provider business mailing address

9 SPRING VIEW WAY
RANCHO SANTA MARGARITA CA
92688-8703
US

V. Phone/Fax

Practice location:
  • Phone: 805-465-2888
  • Fax: 805-465-2889
Mailing address:
  • Phone: 949-742-9594
  • Fax: 805-465-2889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. SHAHRZAD YAZDAN
Title or Position: OPTOMETRIST
Credential: OD
Phone: 805-465-2888