Organization
DR S DAYYANI OD A PROF CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAHROKH DAYYANI OD (OPTOMETRIST)
(310) 319-6122
Entity
Organization
Contact information
Practice address
322 WILSHIRE BLVD, SANTA MONICA, CA 90401-1312
(310) 319-6122
(310) 458-4799
Mailing address
322 WILSHIRE BLVD, SANTA MONICA, CA 90401-1312
(310) 319-6122
(310) 458-4799
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T10307
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GSD001450
—
CA
Enumeration date
01/04/2007
Last updated
08/14/2012
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