Individual provider · NPI-1

Ani Agabalian

Optometrist · Los Angeles, CA

NPI number1285382994
StatusActive
Last updated in NPPESJul 5, 2023

Details

NPI
1285382994
Entity type
Individual (NPI-1)
Name
Ani Agabalian
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 11, 2022
Certification date
Jul 5, 2023
Last updated
Jul 5, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist35291CAYes

Practice location

11301 Wilshire Blvd Bldg 304
Los Angeles, CA 90073-1003

Phone 310-478-3711

Mailing address

2324 Del Mar Rd
Montrose, CA 91020-1404

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