Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 156FC0800X | Contact Lens | 196557 | CA |
N | 156FC0801X | Contact Lens Fitter | 196557 | CA |
Y | 156FX1800X | Optician | 196557 | CA |
NPI | 1124487020 |
---|---|
Provider Name | Miss Saia Amouris Lundy |
First Address | Tarzana, CA 91356-1832 |
Second Address | Tarzana, CA 91356-1832 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/02/2016 |
Last Update Date | 19/02/2016 |