Provider Demographics
NPI:1881036390
Name:OHANIAN, ELINA (OD)
Entity Type:Individual
Prefix:DR
First Name:ELINA
Middle Name:
Last Name:OHANIAN
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 1:1233 W RANCHO VISTA BLVD
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-3947
Mailing Address - Country:US
Mailing Address - Phone:661-575-9090
Mailing Address - Fax:
Practice Address - Street 1:1233 W RANCHO VISTA BLVD
Practice Address - Street 2:#737
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93551-3947
Practice Address - Country:US
Practice Address - Phone:661-575-9090
Practice Address - Fax:661-575-9091
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2014-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14747152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist