Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician | 039119 | CA |
NPI | 1184819260 |
---|---|
Provider Name | Mrs. Anahid Dalgranian |
First Address | Burbank, CA 91502-1528 |
Second Address | Burbank, CA 91502-1528 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/09/2007 |
Last Update Date | 11/09/2007 |