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General NPI Number Information
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NPI Number | 1881795292
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Entity Type | Organization
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Legal Business Name | TOTAL VISION OPTOMETRY CENTER, INC
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13521 SHERMAN WAY SUITE I
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City | VAN NUYS
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State | CA
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Zip | 91405-2894
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Country | US
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Telephone | 818-988-4450
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Fax | 818-988-4485
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Provider Business Mailing Address
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Address Line | 13521 SHERMAN WAY SUITE I
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City | VAN NUYS
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State | CA
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Zip | 91405-2894
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Country | US
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Telephone | 818-988-4450
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Fax | 818-988-4485
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | JEANNETTE IRIARTE
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Credential | O.D
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Telephone | 818-988-4450
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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 | CA8747T
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License Number State | CA
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