Provider Demographics
NPI:1013632272
Name:CHIHA, YARA (OD)
Entity type:Individual
Prefix:
First Name:YARA
Middle Name:
Last Name:CHIHA
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 1:11663 FLORENCIA LN
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-4608
Mailing Address - Country:US
Mailing Address - Phone:818-456-7567
Mailing Address - Fax:
Practice Address - Street 1:2045 ROYAL AVE, STE 234
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065
Practice Address - Country:US
Practice Address - Phone:055-271-4178
Practice Address - Fax:805-584-2477
Is Sole Proprietor?:No
Enumeration Date:2022-10-10
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35332152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist