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General NPI Number Information
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NPI Number | 1043883192
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Entity Type | Organization
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Legal Business Name | MASHIANA OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 07/16/2021
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Last Update Date | 09/24/2021
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Provider Practice Location Address
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Address Line | 1923 CALLE BARCELONA STE 139B
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City | CARLSBAD
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State | CA
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Zip | 92009-8457
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Country | US
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Telephone | 510-935-8540
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1707
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City | ESCONDIDO
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State | CA
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Zip | 92033-1707
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | AMANJOT MASHIANA
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Credential | OD
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Telephone | 510-935-8540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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