Provider Demographics
NPI:1629656095
Name:ARASTEH, LIYAN (OD)
Entity Type:Individual
Prefix:DR
First Name:LIYAN
Middle Name:
Last Name:ARASTEH
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 1:5 ALEJO
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92612-2913
Mailing Address - Country:US
Mailing Address - Phone:949-677-2282
Mailing Address - Fax:
Practice Address - Street 1:4255 CAMPUS DR STE A110
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-8627
Practice Address - Country:US
Practice Address - Phone:949-854-7122
Practice Address - Fax:949-854-7322
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2021-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT34782TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist