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General NPI Number Information
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NPI Number | 1194675108
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Entity Type | Organization
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Legal Business Name | QUEEN OF OPTICS
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 9301 TAMPA AVE UNIT 169
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City | NORTHRIDGE
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State | CA
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Zip | 91324-2577
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Country | US
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Telephone | 213-559-9458
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Fax | 213-559-9476
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Provider Business Mailing Address
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Address Line | 9301 TAMPA AVE UNIT 169
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City | NORTHRIDGE
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State | CA
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Zip | 91324-2577
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Country | US
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Telephone | 213-559-9458
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Fax | 213-559-9476
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Authorized Official
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Title or Position | OWNER
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Name | MERIAM G BESADA
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Credential | OPTICIAN
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Telephone | 781-424-8616
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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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