Individual
FARIA ISLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4560 E CESAR E CHAVEZ AVE, LOS ANGELES, CA 90022-1117
(323) 980-9900
Mailing address
6249 FILLY CT, RANCHO CUCAMONGA, CA 91739-9590
(909) 762-8216
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
34019TLG
CA
Other
Enumeration date
07/28/2018
Last updated
07/28/2018
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