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General NPI Number Information
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NPI Number | 1942975982
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Entity Type | Individual
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Provider Name | YERAZ ANI KOCHKARIAN OD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/11/2021
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Provider Practice Location Address
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Address Line | 1046 W AVENUE K
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City | LANCASTER
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State | CA
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Zip | 93534-5918
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Country | US
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Telephone | 661-942-7313
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Fax |
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Provider Business Mailing Address
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Address Line | 1168 CONCORD ST
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City | GLENDALE
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State | CA
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Zip | 91202-2257
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Country | US
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Telephone | 818-641-6404
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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 | 34906
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License Number State | CA
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