Provider Demographics
NPI:1568877314
Name:PAREKH, PUJA MILAN (OD)
Entity Type:Individual
Prefix:
First Name:PUJA
Middle Name:MILAN
Last Name:PAREKH
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 1:18299 GOLDBARK WAY
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-8424
Mailing Address - Country:US
Mailing Address - Phone:909-717-6971
Mailing Address - Fax:
Practice Address - Street 1:1202 S IDAHO ST STE H
Practice Address - Street 2:
Practice Address - City:LA HABRA
Practice Address - State:CA
Practice Address - Zip Code:90631-0607
Practice Address - Country:US
Practice Address - Phone:562-316-0216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-30
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15384152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist