Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | D 6425 | CA |
NPI | 1023164274 |
---|---|
Provider Name | Mr. Levon Avakian |
First Address | Granada Hills, CA 91344-5612 |
Second Address | Granada Hills, CA 91344-5612 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2007 |
Last Update Date | 07/05/2015 |