Provider Demographics
NPI:1013358852
Name:NASSIRIPOUR, ROSALYN OHEBSIAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ROSALYN
Middle Name:OHEBSIAN
Last Name:NASSIRIPOUR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ROSALYN
Other - Middle Name:
Other - Last Name:OHEBSIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:4454 VAN NUYS BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-5749
Mailing Address - Country:US
Mailing Address - Phone:818-981-2489
Mailing Address - Fax:
Practice Address - Street 1:4454 VAN NUYS BLVD STE C
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-5749
Practice Address - Country:US
Practice Address - Phone:818-981-2489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-09
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14668152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist