Individual
ABOLFAZL MONZAVI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1110 YANKEE DOODLE RD, EAGAN, MN 55121-2092
(651) 454-3970
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2826
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131688500
—
MN
Enumeration date
04/11/2006
Last updated
03/11/2021
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