Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPT 14814 TLG | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPT 14814 TLG | CA |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | OPT 14814 TLG | CA |
N | 152WP0200X | Pediatric Optomitrist | OPT 14814 TLG | CA |
N | 152WS0006X | Sports Vision | OPT 14814 TLG | CA |
N | 152WV0400X | Optomitrist - Vision Therapist | OPT 14814 TLG | CA |
N | 152WX0102X | Occupational Vision | OPT 14814 TLG | CA |
NPI | 1548651565 |
---|---|
Provider Name | Dr. Morvari Ahi |
First Address | Los Altos, CA 94024-6984 |
Second Address | Los Altos, CA 94024-6984 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/02/2015 |
Last Update Date | 12/02/2015 |