Provider Demographics
NPI:1689362931
Name:SERINE MKRTCHYAN, O. D. OPTOMETRY INC.
Entity Type:Organization
Organization Name:SERINE MKRTCHYAN, O. D. OPTOMETRY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MKRTCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:818-573-4867
Mailing Address - Street 1:15435 VANOWEN ST APT 102
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91406-6398
Mailing Address - Country:US
Mailing Address - Phone:818-573-4867
Mailing Address - Fax:
Practice Address - Street 1:15336 DEVONSHIRE ST STE 4
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-2763
Practice Address - Country:US
Practice Address - Phone:818-962-1538
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty