Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPT 14183 TLG | CA |
NPI | 1205123155 |
---|---|
Provider Name | Dr. Dikran Wanes Sarkis |
First Address | Glendale, CA 91205-1381 |
Second Address | Glendale, CA 91205-1381 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2011 |
Last Update Date | 29/06/2011 |