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General NPI Number Information
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NPI Number | 1316367576
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Entity Type | Organization
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Legal Business Name | CALIFORNIA EYE CENTER OPTOMETRY INC
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 06/16/2015
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Provider Practice Location Address
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Address Line | 14624 SHERMAN WAY SUITE# 204
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City | VAN NUYS
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State | CA
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Zip | 91405-2287
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Country | US
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Telephone | 818-780-2020
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Fax | 818-561-3661
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Provider Business Mailing Address
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Address Line | 14624 SHERMAN WAY SUITE# 204
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City | VAN NUYS
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State | CA
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Zip | 91405-2287
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Country | US
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Telephone | 818-780-2020
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Fax | 818-561-3661
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Authorized Official
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Title or Position | OWNER/DOCTOR/PRESIDENT
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Name | DR. HAROUT KHANJIAN
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Credential | O.D.
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Telephone | 818-780-2020
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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 | 14869
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License Number State | CA
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