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General NPI Number Information
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NPI Number | 1164195400
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Entity Type | Organization
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Legal Business Name | PUJA PAREKH O D INC
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Dates
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Enumeration Date | 07/30/2021
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Last Update Date | 07/30/2021
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Provider Practice Location Address
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Address Line | 1202 S IDAHO ST STE H
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City | LA HABRA
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State | CA
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Zip | 90631-0607
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Country | US
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Telephone | 562-316-0216
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Fax |
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Provider Business Mailing Address
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Address Line | 18299 GOLDBARK WAY
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City | YORBA LINDA
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State | CA
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Zip | 92886-8424
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Country | US
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Telephone | 909-717-6971
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | PUJA PAREKH
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Credential | O.D.
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Telephone | 909-717-6971
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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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