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General NPI Number Information
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NPI Number | 1770807745
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Entity Type | Organization
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Legal Business Name | ZAREH SIMONIAN OD INC , A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 03/19/2010
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Last Update Date | 03/19/2010
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Provider Practice Location Address
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Address Line | 232 S BRAND BLVD
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City | GLENDALE
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State | CA
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Zip | 91204-1310
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Country | US
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Telephone | 310-407-5440
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Fax | 310-407-5441
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Provider Business Mailing Address
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Address Line | 232 S BRAND BLVD
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City | GLENDALE
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State | CA
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Zip | 91204-1310
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Country | US
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Telephone | 310-407-5440
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Fax | 310-407-5441
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Authorized Official
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Title or Position | PRESIDENT
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Name | ZAREH SIMONIAN
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Credential | OD
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Telephone | 310-407-5440
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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 | OPT12490
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License Number State | CA
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