Provider Demographics
NPI:1063131456
Name:MARKARIAN, SOSEH (OD)
Entity type:Individual
Prefix:MRS
First Name:SOSEH
Middle Name:
Last Name:MARKARIAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4353 PARK TERRACE DR STE 150
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-4639
Mailing Address - Country:US
Mailing Address - Phone:818-687-6160
Mailing Address - Fax:
Practice Address - Street 1:632 E ORANGE GROVE AVE APT J
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91501-2843
Practice Address - Country:US
Practice Address - Phone:818-687-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA000000152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty