Organization
BROADWAY FAMILY OPTOMETRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BORIS MARDIAN OD (OPTOMETRIST)
(818) 241-7719
Entity
Organization
Contact information
Practice address
113 E BROADWAY, GLENDALE, CA 91205-1006
(818) 241-7719
(818) 241-7719
Mailing address
113 E BROADWAY, GLENDALE, CA 91205-1006
(818) 241-7719
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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