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General NPI Number Information
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NPI Number | 1154426583
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Entity Type | Individual
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Provider Name | LORI SACHIKO NISHIDA-EUGENIO OD
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Gender | Female
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 1032 N HOLLYWOOD WAY
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City | BURBANK
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State | CA
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Zip | 91505-2525
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Country | US
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Telephone | 818-845-3549
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Fax | 818-846-3204
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Provider Business Mailing Address
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Address Line | 2427 N LAMER ST
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City | BURBANK
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State | CA
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Zip | 91504-2228
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Country | US
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Telephone | 818-823-5411
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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 | 9994T
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License Number State | CA
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