Provider Demographics
NPI:1134306574
Name:TALAGA, SALUMEH RASTANI (OD)
Entity Type:Individual
Prefix:DR
First Name:SALUMEH
Middle Name:RASTANI
Last Name:TALAGA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SALUMEH
Other - Middle Name:
Other - Last Name:RASTANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:414 K ST
Mailing Address - Street 2:C/O LENSCRAFTERS AT MACY'S
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95814-3304
Mailing Address - Country:US
Mailing Address - Phone:916-341-0382
Mailing Address - Fax:916-554-7646
Practice Address - Street 1:414 K ST
Practice Address - Street 2:C/O LENSCRAFTERS AT MACY'S
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95814-3304
Practice Address - Country:US
Practice Address - Phone:916-341-0382
Practice Address - Fax:916-554-7646
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2058152W00000X
CAOPT13653152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist