Provider Demographics
NPI:1265463145
Name:YEPREMIAN, ARLENE TANIA (OD)
Entity Type:Individual
Prefix:DR
First Name:ARLENE
Middle Name:TANIA
Last Name:YEPREMIAN
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 1:839 N GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-2128
Mailing Address - Country:US
Mailing Address - Phone:818-240-3937
Mailing Address - Fax:818-240-3933
Practice Address - Street 1:839 N GLENDALE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91206-2128
Practice Address - Country:US
Practice Address - Phone:818-240-3937
Practice Address - Fax:818-240-3933
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12022T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CASD0120220Medicaid
CAU73343Medicare UPIN
CAOP12022Medicare ID - Type Unspecified