Provider Demographics
NPI:1851456727
Name:GHARIB, NEGAR (OD)
Entity Type:Individual
Prefix:DR
First Name:NEGAR
Middle Name:
Last Name:GHARIB
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3831 WINFORD DR
Mailing Address - Street 2:
Mailing Address - City:TARZANA
Mailing Address - State:CA
Mailing Address - Zip Code:91356-5802
Mailing Address - Country:US
Mailing Address - Phone:818-788-1719
Mailing Address - Fax:818-788-4782
Practice Address - Street 1:16542 VENTURA BLVD STE 115
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2099
Practice Address - Country:US
Practice Address - Phone:818-399-1564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2017-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10934T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist