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General NPI Number Information
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NPI Number | 1356416713
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Entity Type | Organization
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Legal Business Name | DR SVETLANA FISHER AN OPTOMETRIC CORPORATION
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 03/29/2024
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Provider Practice Location Address
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Address Line | 21001 SHERMAN WAY STE 14
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City | CANOGA PARK
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State | CA
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Zip | 91303-3679
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Country | US
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Telephone | 747-230-4024
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Fax | 818-276-0009
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Provider Business Mailing Address
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Address Line | 7976 SANTA MONICA BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90046-5109
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Country | US
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Telephone | 323-650-0988
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Fax | 323-650-1579
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Authorized Official
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Title or Position | PRES
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Name | DR. SVETLANA FISHER
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Credential | OD
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Telephone | 323-650-0988
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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 | 9936TPA
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License Number State | CA
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