Provider Demographics
NPI:1700374428
Name:HALEH GUILAK O.D., INC.
Entity Type:Organization
Organization Name:HALEH GUILAK O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:GUILAK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:951-302-8062
Mailing Address - Street 1:32225 TEMECULA PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-6811
Mailing Address - Country:US
Mailing Address - Phone:951-302-8062
Mailing Address - Fax:951-303-9452
Practice Address - Street 1:32225 TEMECULA PKWY
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-6811
Practice Address - Country:US
Practice Address - Phone:951-302-8062
Practice Address - Fax:951-303-9452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-27
Last Update Date:2018-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty