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Organization
SHAKEH BAGDASSAR EYE TO EYE OPTOMETRY
Active
Organization
SHAKEH BAGDASSAR EYE TO EYE OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAKEH BAGDASSAR O.D. (OWNER/ OPTOMETRIST)
(818) 243-1111
Entity
Organization
Contact information
Practice address
1101 N PACIFIC AVE STE 105, GLENDALE, CA 91202-4314
(818) 243-1111
Mailing address
1101 N PACIFIC AVE STE 105, GLENDALE, CA 91202-4314
(818) 243-1111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9792T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SD0097920
—
CA
Enumeration date
07/10/2018
Last updated
07/10/2018
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