Individual
BENJAMIN FOULADIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
403 N PACIFIC COAST HWY, #108, REDONDO BEACH, CA 90277-2839
(310) 318-6665
(310) 318-7117
Mailing address
10660 WILSHIRE BLVD APT 608, LOS ANGELES, CA 90024-7348
(310) 985-2020
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
BOL5070
CA
152W00000X
Optometrist
OPT 9702
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6784926
—
CA
Enumeration date
11/17/2006
Last updated
05/16/2008
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