Healthcare Provider Details

I. General information

NPI: 1447388806
Provider Name (Legal Business Name): ABHI H TRIVEDI O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 SAINT JULIAN PL
COLUMBIA SC
29204-2410
US

IV. Provider business mailing address

100 TRAVERTINE XING
LEXINGTON SC
29072-7032
US

V. Phone/Fax

Practice location:
  • Phone: 803-708-8392
  • Fax:
Mailing address:
  • Phone: 818-287-1578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1391
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number13093
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: