MEDICARE: TANIA STEVENS OPTOMETRIST PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	12072	CA

General Provider Information

NPI Number	:	1053349621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TANIA STEVENS OPTOMETRIST PC

Provider Business Mailing Address
First Line	:	5724 E 7TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-2002
Country	:	US
Telephone Number	:	562-986-6373
Fax Number	:

Provider Business Practice Location Address
First Line	:	5724 E 7TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-2002
Country	:	US
Telephone Number	:	562-986-6373
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TANIA STEVENS
Credential	:	O.D.
Telephone Number	:	562-986-6373

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	09/02/2025

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