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General NPI Number Information
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NPI Number | 1235141144
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Entity Type | Organization
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Legal Business Name | HAMLET MINASVAND PROF CORP
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7188 W SUNSET BLVD UNIT 200
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City | LOS ANGELES
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State | CA
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Zip | 90046-4400
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Country | US
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Telephone | 818-439-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 7188 W SUNSET BLVD UNIT 200
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City | LOS ANGELES
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State | CA
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Zip | 90046-4400
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Country | US
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Telephone | 818-439-2021
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAMLET MINASVAND
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Credential | O.D.
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Telephone | 818-439-2021
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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 | 11567T
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License Number State | CA
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