Provider Demographics
NPI:1518116532
Name:RAWANA, SHAUN HARESH (OD)
Entity Type:Individual
Prefix:DR
First Name:SHAUN
Middle Name:HARESH
Last Name:RAWANA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:50 BLOOR STREET WEST
Mailing Address - Street 2:SUITE C07
Mailing Address - City:TORONTO
Mailing Address - State:ONTARIO
Mailing Address - Zip Code:M4W3L8
Mailing Address - Country:CA
Mailing Address - Phone:416-926-3846
Mailing Address - Fax:416-926-2545
Practice Address - Street 1:50 BLOOR STREET WEST
Practice Address - Street 2:SUITE C07
Practice Address - City:TORONTO
Practice Address - State:ONTARIO
Practice Address - Zip Code:M4W3L8
Practice Address - Country:CA
Practice Address - Phone:416-926-3846
Practice Address - Fax:416-926-2545
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC4589152W00000X
ZZ10019152W00000X
MDTA2119152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist