Fartash Od Inc

LBN: Fartash Od Inc
Fartash Od Inc is an health care organization with primary practice located at 734 N Main St , Corona CA 92880-1439. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Fartash Od Inc can be contacted via phone (951) 737-2020, or through Davis, Shannon via phone (909) 636-9920.

Contact Information

Primary practice address
734 N Main St Corona CA 92880-1439
Phone: (951) 737-2020
Fax: (735) 737-2072
Website:
Map and Directions
Authorized official contact:
Name: Davis, Shannon
Phone: (909) 636-9920

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X

Profile Details

NPI number 1588273833
LBN Legal business name Fartash Od Inc
DBA Doing business as
Authorized official Davis, Shannon
Entity Organization
Organization subpart 1 No
Enumeration date Jul 23rd, 2020
Last updated Jul 23rd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588273833 NPPES
California MEDICAID 1417263500

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