Healthcare Provider Details

I. General information

NPI: 1528996121
Provider Name (Legal Business Name): TANZILA SULIMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16855 VALLEY BLVD STE A-B
FONTANA CA
92335-6621
US

IV. Provider business mailing address

15920 SERENADE LN
FONTANA CA
92336-5076
US

V. Phone/Fax

Practice location:
  • Phone: 909-320-6667
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number36209
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: