Provider Demographics
NPI:1295383552
Name:ASLAM OPTOMETRY GROUP P.C.
Entity Type:Organization
Organization Name:ASLAM OPTOMETRY GROUP P.C.
Other - Org Name:EL SEGUNDO OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ASLAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-414-9595
Mailing Address - Street 1:302 W GRAND AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-5108
Mailing Address - Country:US
Mailing Address - Phone:310-414-9595
Mailing Address - Fax:310-414-0137
Practice Address - Street 1:302 W GRAND AVE STE 1
Practice Address - Street 2:
Practice Address - City:EL SEGUNDO
Practice Address - State:CA
Practice Address - Zip Code:90245-5108
Practice Address - Country:US
Practice Address - Phone:310-414-9595
Practice Address - Fax:310-414-0137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-29
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty