Individual
DR. GARY TAKEO MONJI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
153 N SAN FERNANDO BLVD, BURBANK, CA 91502-1208
(818) 848-6659
(818) 848-7911
Mailing address
153 N SAN FERNANDO BLVD, BURBANK, CA 91502-1208
(818) 848-6659
(818) 848-7911
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9312
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DV547Z
MEDICARE PTAN
CA
05
—
SD0093120
—
CA
Enumeration date
12/05/2006
Last updated
08/19/2015
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