Healthcare Provider Details

I. General information

NPI: 1982256574
Provider Name (Legal Business Name): ROBERTSON OPTOMETRY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2019
Last Update Date: 02/22/2020
Certification Date: 02/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1421 S ROBERTSON BLVD
LOS ANGELES CA
90035-3401
US

IV. Provider business mailing address

930 S ROBERTSON BLVD STE C
LOS ANGELES CA
90035-1642
US

V. Phone/Fax

Practice location:
  • Phone: 310-274-0653
  • Fax:
Mailing address:
  • Phone: 310-274-0653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. ESTHER SOPHIA YANG
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: OD
Phone: 310-274-0653