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General NPI Number Information
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NPI Number | 1073069373
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Entity Type | Individual
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Provider Name | MOSTAFA AHADY OD
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Gender | Male
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 7044 OAKDALE AVE.
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City | WINNETKA
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State | CA
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Zip | 91306
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Country | US
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Telephone | 818-300-4575
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Fax |
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Provider Business Mailing Address
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Address Line | 7044 OAKDALE AVE
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City | WINNETKA
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State | CA
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Zip | 91306-3626
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Country | US
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Telephone | 818-300-4575
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 33551
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License Number State | CA
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