Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 34054TLG | CA |
NPI | 1013497239 |
---|---|
Provider Name | Amanjot Mashiana |
First Address | San Diego, CA 92108-1523 |
Second Address | San Diego, CA 92108-1523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2018 |
Last Update Date | 09/06/2021 |