Provider Demographics
NPI:1477934776
Name:RAEISIAN, ARMINA (OD)
Entity Type:Individual
Prefix:DR
First Name:ARMINA
Middle Name:
Last Name:RAEISIAN
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 1:2621 S BRISTOL ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-5700
Mailing Address - Country:US
Mailing Address - Phone:703-629-8340
Mailing Address - Fax:
Practice Address - Street 1:294 HIGHLAND AVE
Practice Address - Street 2:APT #3
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-3271
Practice Address - Country:US
Practice Address - Phone:703-629-8340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-11
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33363152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist