Individual
MISS DASHAINI VICTORIA RETNASOTHIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD, MSC, BSC
Contact information
Practice address
5460 E LA PALMA AVE, ANAHEIM, CA 92807
(714) 463-7500
Mailing address
5460 E LA PALMA AVE, ANAHEIM, CA 92807-2023
(714) 463-7500
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
14413
CA
152W00000X
Optometrist
8326T
TX
152WP0200X
Pediatric Optometrist
14413
CA
152WV0400X
Vision Therapy Optometrist
14413
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112409104
—
TX
01
—
1861493140
GROUP NPI
TX
Enumeration date
07/09/2012
Last updated
09/05/2018
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