Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | 33784TLG | CA |
Y | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 33784TLF | CA |
NPI | 1033636766 |
---|---|
Provider Name | Lilia Babakhan |
First Address | Burbank, CA 91504-3281 |
Second Address | Encino, CA 91436-4325 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2017 |
Last Update Date | 23/08/2017 |