Provider Demographics
NPI:1356332225
Name:SCHLANGER, JAY LAWRENCE (OD)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:LAWRENCE
Last Name:SCHLANGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:16055 VENTURA BLVD
Mailing Address - Street 2:SUITE 690
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2601
Mailing Address - Country:US
Mailing Address - Phone:818-789-2030
Mailing Address - Fax:818-789-2025
Practice Address - Street 1:16055 VENTURA BLVD
Practice Address - Street 2:SUITE 690
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2601
Practice Address - Country:US
Practice Address - Phone:818-789-2030
Practice Address - Fax:818-789-2025
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA06343152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA477-99-085OtherSTATE
T70107Medicare UPIN
OP6343AMedicare PIN