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NPI Code Detail

MEDICARE: ZAREH SIMONIAN OD INC , A PROFESSIONAL CORPORATION

MEDICARE: ZAREH SIMONIAN OD INC , A PROFESSIONAL CORPORATION
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
1152W00000XOptometristOPT12490CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1OPT12490OTHERCACA LICENCE

General Provider Information

NPI Number : 1770807745
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZAREH SIMONIAN OD INC , A PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 232 S BRAND BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91204-1310
Country : US
Telephone Number : 310-407-5440
Fax Number : 310-407-5441
Provider Business Practice Location Address
First Line : 232 S BRAND BLVD
Second Line :
City : GLENDALE
State : CA
Zip : 91204-1310
Country : US
Telephone Number : 310-407-5440
Fax Number : 310-407-5441
Authorized Official
Title or Position : PRESIDENT
Name : ZAREH SIMONIAN
Credential : OD
Telephone Number : 310-407-5440
Provider Enumeration Date : 03/19/2010
Last Update Date : 03/19/2010

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