Provider Demographics
NPI:1609315654
Name:SARIA IQBAL OD INC
Entity Type:Organization
Organization Name:SARIA IQBAL OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:SARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:IQBAL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:714-256-4753
Mailing Address - Street 1:200 BREA MALL
Mailing Address - Street 2:MACYS LENSCRAFTERS
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-5762
Mailing Address - Country:US
Mailing Address - Phone:714-256-0216
Mailing Address - Fax:
Practice Address - Street 1:200 BREA MALL
Practice Address - Street 2:MACYS LENSCRAFTERS
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-5762
Practice Address - Country:US
Practice Address - Phone:714-256-0216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT33357TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty