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General NPI Number Information
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NPI Number | 1285302901
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Entity Type | Individual
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Provider Name | MANIA GHANEM OD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2021
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 906 SAN FERNANDO RD
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City | SAN FERNANDO
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State | CA
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Zip | 91340-3311
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Country | US
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Telephone | 818-361-1513
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Fax |
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Provider Business Mailing Address
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Address Line | 22501 SCHOOLCRAFT ST
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City | WEST HILLS
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State | CA
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Zip | 91307-2636
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Country | US
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Telephone | 818-923-8916
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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 | OPT35021
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License Number State | CA
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