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General NPI Number Information
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NPI Number | 1952589442
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Entity Type | Organization
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Legal Business Name | OPTOMETRIX
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 06/04/2014
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Provider Practice Location Address
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Address Line | 11701 WILSHIRE BLVD STE 10
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City | LOS ANGELES
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State | CA
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Zip | 90025-1544
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Country | US
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Telephone | 310-820-7866
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Fax | 310-286-4896
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Provider Business Mailing Address
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Address Line | 11701 WILSHIRE BLVD STE 10
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City | LOS ANGELES
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State | CA
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Zip | 90025-1544
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Country | US
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Telephone | 310-820-7866
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Fax | 310-826-4896
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Authorized Official
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Title or Position | DOCTOR/ OWNER
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Name | DR. MYLES JOSEF ZAKHEIM
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Credential | O.D.
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Telephone | 310-820-7866
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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 | 6586
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License Number State | CA
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