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NPI Code Detail

MEDICARE: DR. MONISHA SHONA PARIPATYADAR O.D.

MEDICARE:  DR. MONISHA SHONA PARIPATYADAR  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
1152W00000XOptometrist14619CA

General Provider Information

NPI Number : 1841630696
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MONISHA SHONA PARIPATYADAR O.D.
Provider Business Mailing Address
First Line : 10142 NATIONAL BLVD APT 104
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-3879
Country : US
Telephone Number : 408-623-7206
Fax Number :
Provider Business Practice Location Address
First Line : 1760 S PACIFIC COAST HWY
Second Line :
City : REDONDO BEACH
State : CA
Zip : 90277-5902
Country : US
Telephone Number : 310-540-2970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2013
Last Update Date : 06/26/2013

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