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General NPI Number Information
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NPI Number | 1790231009
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Entity Type | Individual
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Provider Name | ANI KAZARIAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 08/27/2016
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 17310 VENTURA BLVD
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City | ENCINO
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State | CA
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Zip | 91316-3904
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Country | US
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Telephone | 818-728-6800
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Fax | 818-728-1466
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Provider Business Mailing Address
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Address Line | 9448 CHARRICK DR
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City | TUJUNGA
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State | CA
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Zip | 91042-3205
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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 |
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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 | 33452
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License Number State | CA
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