Individual
SELVIN ROBIN GNANAKKAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
7122 N 59TH AVE FL 1, GLENDALE, AZ 85301-2436
(623) 931-1043
(602) 535-3165
Mailing address
2661 RIVA RD STE 1030, ANNAPOLIS, MD 21401-7131
(667) 354-5528
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
0618001366
VA
152W00000X
Optometrist
Primary
1127
AZ
152W00000X
Optometrist
1976-922AT
LA
152W00000X
Optometrist
21201-875
WI
152W00000X
Optometrist
OEG003214
PA
152W00000X
Optometrist
Primary
OPT-001127
AZ
152W00000X
Optometrist
TPOP129
FL
207W00000X
Ophthalmology Physician
TA1769
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
900139064
—
AZ
Enumeration date
12/20/2006
Last updated
03/21/2026
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