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General NPI Number Information
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NPI Number | 1982885273
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Entity Type | Individual
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Provider Name | HAMLET MINASVAND
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Gender | Male
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 09/10/2015
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Provider Practice Location Address
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Address Line | 311 N VERDUGO RD SUITE A
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City | GLENDALE
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State | CA
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Zip | 91206-3944
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Country | US
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Telephone | 323-882-8246
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Fax |
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Provider Business Mailing Address
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Address Line | 5181 HOLLYWOOD BLVD
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City | LOS ANGELES
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State | CA
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Zip | 90027-6113
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Country | US
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Telephone | 323-662-9629
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Fax | 323-662-0915
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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 | 11567
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License Number State | CA
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