Provider Demographics
NPI:1689619512
Name:ATTAR, ATOUSA (OD)
Entity Type:Individual
Prefix:
First Name:ATOUSA
Middle Name:
Last Name:ATTAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 LOMA VISTA RD
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-2916
Mailing Address - Country:US
Mailing Address - Phone:805-648-3085
Mailing Address - Fax:805-648-7027
Practice Address - Street 1:300 THE SHOPS BLVD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-9269
Practice Address - Country:US
Practice Address - Phone:949-347-1287
Practice Address - Fax:949-347-1256
Is Sole Proprietor?:No
Enumeration Date:2006-06-17
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAOPT12544152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA205153800OtherUS DEPT. OF LABOR