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General NPI Number Information
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NPI Number | 1710489927
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Entity Type | Organization
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Legal Business Name | DR. PARIYA SHAMSAEE, O.D., PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/03/2018
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Last Update Date | 03/03/2018
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Provider Practice Location Address
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Address Line | 910 EASTLAKE PKWY
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City | CHULA VISTA
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State | CA
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Zip | 91914-3558
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Country | US
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Telephone | 619-482-7130
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 500481
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City | SAN DIEGO
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State | CA
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Zip | 92150-0481
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. PARIYA SHAMSAEE
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Credential | OD
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Telephone | 619-482-7130
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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 | 33643
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License Number State | CA
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