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General NPI Number Information
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NPI Number | 1649762014
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Entity Type | Organization
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Legal Business Name | HASHEMI OPHTHALMOLOGY, PC
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 08/28/2018
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Provider Practice Location Address
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Address Line | 5353 BALBOA BLVD STE 110
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City | ENCINO
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State | CA
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Zip | 91316
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Country | US
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Telephone | 818-387-6565
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Fax | 818-387-6288
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Provider Business Mailing Address
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Address Line | 5353 BALBOA BLVD STE 110
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City | ENCINO
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State | CA
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Zip | 91316-2859
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Country | US
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Telephone | 818-387-6565
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Fax | 818-387-6288
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Authorized Official
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Title or Position | OWNER
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Name | DR. NAFISEH HASHEMI
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Credential | MD
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Telephone | 818-387-6565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207WX0109X
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Taxonomy Name | Neuro-ophthalmology Physician
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License Number | A136366
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License Number State | CA
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