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General NPI Number Information
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NPI Number | 1851979439
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Entity Type | Organization
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Legal Business Name | OPTICAL TIME, INC.
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Dates
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Enumeration Date | 04/01/2021
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Last Update Date | 04/01/2021
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Provider Practice Location Address
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Address Line | 18725 VENTURA BLVD
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City | TARZANA
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State | CA
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Zip | 91356-3302
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Country | US
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Telephone | 818-344-7100
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Fax | 818-344-7100
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Provider Business Mailing Address
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Address Line | 18725 VENTURA BLVD
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City | TARZANA
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State | CA
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Zip | 91356-3302
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Country | US
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Telephone | 818-344-7100
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Fax | 818-344-7107
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Authorized Official
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Title or Position | CFO
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Name | DR. SISSAG BOGHIKIAN
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Credential | DPA
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Telephone | 213-304-7477
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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