MEDICARE: PUJA MILAN PAREKH 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	15384	CA

General Provider Information

NPI Number	:	1568877314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PUJA MILAN PAREKH O.D.

Provider Business Mailing Address
First Line	:	18299 GOLDBARK WAY
Second Line	:
City	:	YORBA LINDA
State	:	CA
Zip	:	92886-8424
Country	:	US
Telephone Number	:	909-717-6971
Fax Number	:

Provider Business Practice Location Address
First Line	:	1202 S IDAHO ST STE H
Second Line	:
City	:	LA HABRA
State	:	CA
Zip	:	90631-0607
Country	:	US
Telephone Number	:	562-316-0216
Fax Number	:

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

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	09/02/2021

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