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General NPI Number Information
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NPI Number | 1568706364
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Entity Type | Organization
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Legal Business Name | DR. SHAD S. SAREMI, O.D., PROF. CORP
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 13550 W. PAXTON ST
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City | PACOIMA
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State | CA
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Zip | 91331
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Country | US
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Telephone | 818-890-9600
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Fax | 818-890-9697
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Provider Business Mailing Address
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Address Line | 13550 W. PAXTON ST
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City | PACOIMA
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State | CA
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Zip | 91331
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Country | US
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Telephone | 818-890-9600
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Fax | 818-890-9697
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHAHRIYAR SAREMI
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Credential | O.D.
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Telephone | 818-890-9600
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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 | 12171 TPG
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License Number State | CA
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