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Individual

ANI KOUSSAYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
10605 BALBOA BLVD STE 230, GRANADA HILLS, CA 91344-6344
(818) 368-4114
Mailing address
10605 BALBOA BLVD STE 230, GRANADA HILLS, CA 91344-6344

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
33731TLG
CA

Other

Enumeration date
07/09/2017
Last updated
04/09/2019
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