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Individual

DR. ROUSHANAK FADAVI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
4 ARCATA, MISSION VIEJO, CA 92692-5138
(201) 725-9285
Mailing address
30212 TOMAS STE 170, RANCHO SANTA MARGARITA, CA 92688-2174
(949) 589-0767

Taxonomy

Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
14103T
CA

Other

Enumeration date
01/25/2013
Last updated
01/25/2013
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