Healthcare Provider Details

I. General information

NPI: 1386598266
Provider Name (Legal Business Name): DAVIT MEHRABYAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/25/2026
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5123 W SUNSET BLVD STE 209
LOS ANGELES CA
90027-5779
US

IV. Provider business mailing address

5123 W SUNSET BLVD STE 209
LOS ANGELES CA
90027-5779
US

V. Phone/Fax

Practice location:
  • Phone: 818-858-3826
  • Fax:
Mailing address:
  • Phone: 818-858-3826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number238114
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: