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General NPI Number Information
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NPI Number | 1114478997
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Entity Type | Organization
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Legal Business Name | SUKIASSIANS OPTOMETRY INC.
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Dates
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Enumeration Date | 10/17/2016
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Last Update Date | 10/17/2016
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Provider Practice Location Address
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Address Line | 9027 TAMPA AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3524
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Country | US
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Telephone | 818-349-7617
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Fax |
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Provider Business Mailing Address
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Address Line | 9027 TAMPA AVE
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3524
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Country | US
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Telephone | 818-349-7617
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OPTOMETRIST
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Name | DR. CHRIS KARLOS SUKIASSIANS
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Credential | O.D.
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Telephone | 818-203-7123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 12246-T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 12246-T
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License Number State | CA
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