| |
839 N Glendale Ave, Glendale, CA 91206-2128 | |
(818) 240-3937 | |
(818) 240-3933 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center |
Location | 839 N Glendale Ave, Glendale, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043547482 | NPI | - | NPPES |
1043547482 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 12022T (California) | Secondary |
261Q00000X | Clinic/center | 12022T (California) | Primary |
Provider Name | Arlene Tania Yepremian |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1265463145 PECOS PAC ID: 3476740176 Enrollment ID: I20101207000921 |
Mailing Address | Practice Location Address |
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839 N Glendale Ave, Glendale, CA 91206-2128 Ph: (818) 240-3937 | 839 N Glendale Ave, Glendale, CA 91206-2128 Ph: (818) 240-3937 |