Provider Demographics
NPI:1316442742
Name:TAMRAZIAN, ANIKA (OD)
Entity type:Individual
Prefix:DR
First Name:ANIKA
Middle Name:
Last Name:TAMRAZIAN
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 1:3070 HONOLULU AVE
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-3713
Mailing Address - Country:US
Mailing Address - Phone:818-331-6590
Mailing Address - Fax:
Practice Address - Street 1:14006 RIVERSIDE DR STE 274
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-1963
Practice Address - Country:US
Practice Address - Phone:818-461-0595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34206TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty