Provider Demographics
NPI:1063041630
Name:RANI, MONICA (OD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:RANI
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 1:4505 BARRANCA PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92604-4797
Mailing Address - Country:US
Mailing Address - Phone:949-857-0676
Mailing Address - Fax:949-857-0676
Practice Address - Street 1:4505 BARRANCA PKWY STE C
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92604-4797
Practice Address - Country:US
Practice Address - Phone:949-857-0676
Practice Address - Fax:949-857-0676
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-06
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT34683TLG152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist