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Organization
MERCEDEH MOTAMENI, O.D., AN OPTOMETRIC CORPORATION
Active
Organization
MERCEDEH MOTAMENI, O.D., AN OPTOMETRIC CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MERCEDEH MOTAMENI O.D. (OPTOMETRIST, OWNER)
(310) 391-6311
Entity
Organization
Contact information
Practice address
4125 SEPULVEDA BLVD, CULVER CITY, CA 90230-4706
(310) 391-6311
(310) 390-1874
Mailing address
4125 SEPULVEDA BLVD, CULVER CITY, CA 90230-4706
(310) 391-6311
(310) 390-1874
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9453T
CA
152WC0802X
Corneal and Contact Management Optometrist
9453T
CA
152WP0200X
Pediatric Optometrist
9453T
CA
152WV0400X
Vision Therapy Optometrist
9453T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0094530
—
CA
Enumeration date
02/10/2012
Last updated
01/10/2017
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