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General NPI Number Information
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NPI Number | 1629247119
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Entity Type | Individual
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Provider Name | AFSHIN TONY SADIGHPOUR O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/28/2008
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Last Update Date | 11/29/2021
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Provider Practice Location Address
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Address Line | 3451 W CENTURY BLVD
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City | INGLEWOOD
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State | CA
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Zip | 90303-1227
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Country | US
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Telephone | 310-419-3315
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Fax |
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Provider Business Mailing Address
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Address Line | 1707 PACIFIC COAST HWY UNIT 223
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City | HERMOSA BEACH
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State | CA
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Zip | 90254-3241
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Country | US
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Telephone | 323-333-8136
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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 | 12723
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License Number State | CA
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