Provider Demographics
NPI:1245420694
Name:UNAL, ASUMAN AYSE (OD)
Entity Type:Individual
Prefix:
First Name:ASUMAN
Middle Name:AYSE
Last Name:UNAL
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 1:28121 CROWN VALLEY PKWY
Mailing Address - Street 2:SUITE G
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-1491
Mailing Address - Country:US
Mailing Address - Phone:949-716-3937
Mailing Address - Fax:949-716-4433
Practice Address - Street 1:28121 CROWN VALLEY PKWY
Practice Address - Street 2:SUITE G
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-1491
Practice Address - Country:US
Practice Address - Phone:949-716-3937
Practice Address - Fax:949-716-4433
Is Sole Proprietor?:No
Enumeration Date:2007-07-31
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14370152W00000X
DEI4-0000035152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE116420D9AMedicare PIN