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General NPI Number Information
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NPI Number | 1912389354
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Entity Type | Individual
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Provider Name | ERICA DANIELLE BARANWAL O.D.
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Gender | Female
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Dates
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Enumeration Date | 06/22/2015
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Last Update Date | 01/09/2025
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Provider Practice Location Address
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Address Line | 505 S VIRGIL AVE STE 300
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City | LOS ANGELES
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State | CA
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Zip | 90020-1406
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Country | US
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Telephone | 213-384-5222
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Fax | 213-380-3937
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Provider Business Mailing Address
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Address Line | 3651 WELLINGTON RD
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City | LOS ANGELES
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State | CA
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Zip | 90016-4260
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Country | US
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Telephone | 614-309-7823
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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 | 35790
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License Number State | CA
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