Individual
IRINA YAKUBIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
718 MONTANA AVE, SANTA MONICA, CA 90403-1404
(310) 917-4474
Mailing address
9201 W SUNSET BLVD STE 709, WEST HOLLYWOOD, CA 90069-3708
(310) 275-5533
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34722
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MY6983313
CAQH ID
—
Enumeration date
12/07/2020
Last updated
04/13/2024
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