Provider Demographics
NPI:1649588336
Name:FOAD J. SHIRAZIAN
Entity Type:Organization
Organization Name:FOAD J. SHIRAZIAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FOAD
Authorized Official - Middle Name:J
Authorized Official - Last Name:SHIRAZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-757-3200
Mailing Address - Street 1:18399 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-4233
Mailing Address - Country:US
Mailing Address - Phone:818-757-3200
Mailing Address - Fax:818-757-0318
Practice Address - Street 1:18399 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-4233
Practice Address - Country:US
Practice Address - Phone:818-757-3200
Practice Address - Fax:818-757-0318
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-16
Last Update Date:2010-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty