Provider Demographics
NPI:1245647221
Name:RADZINSKY, ALIONA (BS, OD)
Entity type:Individual
Prefix:DR
First Name:ALIONA
Middle Name:
Last Name:RADZINSKY
Suffix:
Gender:F
Credentials:BS, OD
Other - Prefix:DR
Other - First Name:ALIONA
Other - Middle Name:
Other - Last Name:PITCHKAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BS, OD
Mailing Address - Street 1:14006 RIVERSIDE DR
Mailing Address - Street 2:STE 274
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-1963
Mailing Address - Country:US
Mailing Address - Phone:818-461-0595
Mailing Address - Fax:
Practice Address - Street 1:14006 RIVERSIDE DR
Practice Address - Street 2:STE 274
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-1963
Practice Address - Country:US
Practice Address - Phone:816-461-0595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-22
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15069152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOPT15069TLGOtherCALIFORIA LICENSE