Provider Demographics
NPI:1164195400
Name:PUJA PAREKH O D INC
Entity Type:Organization
Organization Name:PUJA PAREKH O D INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:PUJA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREKH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:909-717-6971
Mailing Address - Street 1:18299 GOLDBARK WAY
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-8424
Mailing Address - Country:US
Mailing Address - Phone:909-717-6971
Mailing Address - Fax:
Practice Address - Street 1:1202 S IDAHO ST STE H
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-0607
Practice Address - Country:US
Practice Address - Phone:562-316-0216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-30
Last Update Date:2021-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1568877314OtherEYEMED