Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 10449T | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 10449T | CA |
NPI | 1003256579 |
---|---|
Provider Name | Angella Yahoudai |
First Address | Los Angeles, CA 90049-2930 |
Second Address | Valencia, CA 91355-1814 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2013 |
Last Update Date | 23/01/2018 |