Organization
A. SADEGHIAN OPTOMETRIC CORPORATION
Active
Other names
Corona Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
BARBARA A ROOS CPC (BILLING MANAGER)
(630) 541-5040
Entity
Organization
Contact information
Practice address
1501 RIMPAU AVE, SUITE B104, CORONA, CA 92881-3225
(951) 898-2010
Mailing address
1501 RIMPAU AVE, SUITE B104, CORONA, CA 92881-3225
(951) 898-2010
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
12354T
CA
152WC0802X
Corneal and Contact Management Optometrist
12354T
CA
152WL0500X
Low Vision Rehabilitation Optometrist
12354T
CA
152WP0200X
Pediatric Optometrist
12354T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ER708A
PTAN
CA
Enumeration date
02/12/2007
Last updated
12/15/2011
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