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General NPI Number Information
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NPI Number | 1942982624
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Entity Type | Organization
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Legal Business Name | WESTERN OPTOMETRIC CENTER INC
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Dates
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Enumeration Date | 08/02/2023
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 237 N WESTERN AVE
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City | LOS ANGELES
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State | CA
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Zip | 90004-4107
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Country | US
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Telephone | 323-469-1929
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Fax | 323-672-8393
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Provider Business Mailing Address
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Address Line | 2146 LAS LUNAS ST
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City | PASADENA
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State | CA
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Zip | 91107-2420
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Country | US
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Telephone | 818-913-0590
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TANYA CHALJIAN
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Credential | OD
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Telephone | 818-913-0590
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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 |
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License Number State |
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