Provider Demographics
NPI:1003332248
Name:HAGHVERDIAN, ARGINA (OPTOMETRIST (OD))
Entity Type:Individual
Prefix:
First Name:ARGINA
Middle Name:
Last Name:HAGHVERDIAN
Suffix:
Gender:F
Credentials:OPTOMETRIST (OD)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 N CENTRAL AVE APT 10
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91202-1892
Mailing Address - Country:US
Mailing Address - Phone:818-325-9616
Mailing Address - Fax:
Practice Address - Street 1:9420 RESEDA BLVD STE 8
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-6005
Practice Address - Country:US
Practice Address - Phone:818-646-9449
Practice Address - Fax:818-646-9449
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-18
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33807TLG152W00000X
CAOPT33807-TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty