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General NPI Number Information
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NPI Number | 1760881270
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Entity Type | Organization
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Legal Business Name | LILIT YESAYAN OD A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/20/2014
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Last Update Date | 10/04/2023
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Provider Practice Location Address
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Address Line | 1141 N BRAND BLVD STE 201
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City | GLENDALE
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State | CA
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Zip | 91202-3647
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Country | US
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Telephone | 818-303-3316
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 N BRAND BLVD STE 201
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City | GLENDALE
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State | CA
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Zip | 91202-3647
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Country | US
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Telephone | 818-303-3316
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | LILIT YESAYAN
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Credential |
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Telephone | 818-303-3316
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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 | 14928
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License Number State | CA
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