Provider Demographics
NPI:1447618111
Name:GIRISGEN & KOPOLOW OD, PC
Entity Type:Organization
Organization Name:GIRISGEN & KOPOLOW OD, PC
Other - Org Name:PEARLE VISION SUNSET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SEFIR
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRISGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-733-6764
Mailing Address - Street 1:2021 N RAINBOW BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89108-7098
Mailing Address - Country:US
Mailing Address - Phone:702-452-2020
Mailing Address - Fax:702-437-5502
Practice Address - Street 1:1381 W SUNSET RD STE 120
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89014-8628
Practice Address - Country:US
Practice Address - Phone:702-452-2020
Practice Address - Fax:702-437-5502
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GIRISGEN & KOPOLOW OD, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-02-09
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty