Provider Demographics
NPI:1821533647
Name:TALIN AMADIAN, OD, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:TALIN AMADIAN, OD, A PROFESSIONAL CORPORATION
Other - Org Name:WOODLEY OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TALIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AMADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:818-789-2030
Mailing Address - Street 1:16055 VENTURA BLVD STE 690
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2631
Mailing Address - Country:US
Mailing Address - Phone:818-789-2030
Mailing Address - Fax:818-789-2025
Practice Address - Street 1:16055 VENTURA BLVD STE 690
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2631
Practice Address - Country:US
Practice Address - Phone:818-789-2030
Practice Address - Fax:818-789-2025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-01-03
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15233152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty