Healthcare Provider Details

I. General information

NPI: 1417923590
Provider Name (Legal Business Name): MONICA ANNE SLIVAR O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1509 HAWTHORNE BLVD STE 105
REDONDO BEACH CA
90278-3957
US

IV. Provider business mailing address

1509 HAWTHORNE BLVD STE 105
REDONDO BEACH CA
90278-3957
US

V. Phone/Fax

Practice location:
  • Phone: 424-247-2020
  • Fax: 424-402-3004
Mailing address:
  • Phone: 424-247-2020
  • Fax: 424-402-3004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10111T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: