Provider Demographics
NPI:1194443820
Name:PAYMAUN ASNAASHARI OPTOMETRIC CORPORATION
Entity type:Organization
Organization Name:PAYMAUN ASNAASHARI OPTOMETRIC CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAYMAUN
Authorized Official - Middle Name:
Authorized Official - Last Name:ASNAASHARI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-646-9155
Mailing Address - Street 1:960 FULTON AVE STE 400
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4558
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:960 FULTON AVE STE 400
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4558
Practice Address - Country:US
Practice Address - Phone:916-646-9155
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty