Healthcare Provider Details

I. General information

NPI: 1871054692
Provider Name (Legal Business Name): ZOYA OPTICAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2019
Last Update Date: 03/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1154 N POINT CIR
ALPHARETTA GA
30022-4855
US

IV. Provider business mailing address

1154 N POINT CIR
ALPHARETTA GA
30022-4855
US

V. Phone/Fax

Practice location:
  • Phone: 770-667-8060
  • Fax: 770-667-2024
Mailing address:
  • Phone: 770-667-8060
  • Fax: 770-667-2024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. MASTOUREH AHMADPOUR
Title or Position: OPTOMETRIST/OWNER
Credential: OD
Phone: 404-931-3304