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General NPI Number Information
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NPI Number | 1821533647
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Entity Type | Organization
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Legal Business Name | TALIN AMADIAN, OD, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/03/2017
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Last Update Date | 02/21/2023
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Provider Practice Location Address
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Address Line | 16055 VENTURA BLVD STE 690
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City | ENCINO
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State | CA
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Zip | 91436-2631
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Country | US
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Telephone | 818-789-2030
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Fax | 818-789-2025
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Provider Business Mailing Address
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Address Line | 16055 VENTURA BLVD STE 690
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City | ENCINO
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State | CA
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Zip | 91436-2631
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Country | US
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Telephone | 818-789-2030
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Fax | 818-789-2025
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Authorized Official
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Title or Position | OWNER
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Name | DR. TALIN AMADIAN
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Credential | OD
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Telephone | 818-789-2030
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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 | 15233
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License Number State | CA
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