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Organization
NIKKI IRAVANI OD A PROFESSIONAL CORPORATION
Active
Organization
NIKKI IRAVANI OD A PROFESSIONAL CORPORATION
Active
Other names
EyeXam Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NIKOO IRAVANI O.D. (FOUNDER/CEO)
(408) 528-7100
Entity
Organization
Contact information
Practice address
2702 AUGUSTINE DR STE 120, SANTA CLARA, CA 95054-2940
(408) 528-7100
Mailing address
2702 AUGUSTINE DR STE 120, SANTA CLARA, CA 95054-2940
(408) 528-7100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9985T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13920487
CAQH
CA
01
—
1659803088
NPI 1
CA
Enumeration date
05/02/2017
Last updated
10/24/2017
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