Provider Demographics
NPI:1295393668
Name:MOHAN, NACHER
Entity Type:Individual
Prefix:DR
First Name:NACHER
Middle Name:
Last Name:MOHAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240-610 SIXTH STREET
Mailing Address - Street 2:
Mailing Address - City:NEW WESTMINSTER
Mailing Address - State:BRITISH COLUMBIA
Mailing Address - Zip Code:V3L3C2
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:240 - 610 SIXTH STREET
Practice Address - Street 2:
Practice Address - City:NEW WESTMINSTER
Practice Address - State:BRITISH COLUMBIA
Practice Address - Zip Code:V3L 3C2
Practice Address - Country:CA
Practice Address - Phone:604-522-6929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-31
Last Update Date:2019-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3617152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist