Individual
VYACHESLAV SAMSANOVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18663 VENTURA BLVD, SUITE #108, TARZANA, CA 91356-4162
(818) 881-1485
Mailing address
18663 VENTURA BLVD, SUITE #108, TARZANA, CA 91356-4162
(818) 881-1485
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
SL4691
CA
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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