MEDICARE: DR. MICHAEL VAROUJAN TERZIAN O.D.

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	12364T	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	WOP12364A	OTHER	CA	MEDICARE MEMBER ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134253693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL VAROUJAN TERZIAN O.D.

Provider Business Mailing Address
First Line	:	11151 TAMPA AVE
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91326-2254
Country	:	US
Telephone Number	:	818-366-9664
Fax Number	:	818-368-5314

Provider Business Practice Location Address
First Line	:	11151 TAMPA AVE
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91326-2254
Country	:	US
Telephone Number	:	818-366-9664
Fax Number	:	818-368-5314

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	06/10/2016

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Directions to “ DR. MICHAEL VAROUJAN TERZIAN O.D.” Practice Location

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