Healthcare Provider Details

I. General information

NPI: 1811620875
Provider Name (Legal Business Name): ELHAM ZARABIAN OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4424 TWEEDY BLVD
SOUTH GATE CA
90280-6304
US

IV. Provider business mailing address

530 S MAIN ST STE 600
ORANGE CA
92868-4544
US

V. Phone/Fax

Practice location:
  • Phone: 323-438-3520
  • Fax:
Mailing address:
  • Phone: 714-480-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: CASANDRA BREDEK
Title or Position: DIRECTOR
Credential:
Phone: 657-391-8473