Healthcare Provider Details

I. General information

NPI: 1881499598
Provider Name (Legal Business Name): ALAMEDA FAMILY OPTOMETRY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2025
Last Update Date: 02/17/2025
Certification Date: 02/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 S ALAMEDA ST UNIT G2930
VERNON CA
90058-2010
US

IV. Provider business mailing address

PO BOX 58125
VERNON CA
90058-0125
US

V. Phone/Fax

Practice location:
  • Phone: 323-231-0005
  • Fax: 323-231-0006
Mailing address:
  • Phone: 323-231-0005
  • Fax: 323-231-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. HOVHANNES HOVHANNISYAN
Title or Position: PRESIDENT
Credential: OD
Phone: 818-397-3523