Individual
MR. MIKHAIL SERGEY MIKHAYLYANTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
14659 TITUS STREET, PANORAMA CITY, CA 91402-4940
(818) 785-7070
(818) 785-7070
Mailing address
9000 VANALDEN AVE, UNIT # 104, NORTHRIDGE, CA 91324-4137
(818) 341-8987
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D 6442
CA
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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