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General NPI Number Information
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NPI Number | 1194401745
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Entity Type | Individual
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Provider Name | ANJALI NICOLE PARAMANANDAM OD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 06/27/2023
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Provider Practice Location Address
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Address Line | US-491
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City | SHIPROCK
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State | NM
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Zip | 87420
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Country | US
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Telephone | 505-368-6001
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Fax |
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Provider Business Mailing Address
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Address Line | 210 VIA HACIENDA
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City | NEWBURY PARK
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State | CA
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Zip | 91320-6836
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Country | US
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Telephone | 805-410-2752
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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 | OPT.0003931
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License Number State | CO
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