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Organization

DAWN REVERSPECTIVE EYES LLC

Active
Other names
Eagle Rock Optometry
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SEPIDEH OMIDGHAEMI OD (OWNER/OPTOMETRIST)
(323) 739-6092
Entity
Organization

Contact information

Practice address
1605 COLORADO BLVD, LOS ANGELES, CA 90041-1402
(323) 739-6092
Mailing address
1605 COLORADO BLVD, LOS ANGELES, CA 90041-1402

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
152WC0802X
Corneal and Contact Management Optometrist
152WP0200X
Pediatric Optometrist
152WS0006X
Sports Vision Optometrist
152WX0102X
Occupational Vision Optometrist

Other

Enumeration date
01/08/2021
Last updated
01/08/2021
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