Provider Demographics
NPI:1356756928
Name:CANLAS, AIRA (OD)
Entity type:Individual
Prefix:DR
First Name:AIRA
Middle Name:
Last Name:CANLAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:AIRA-LYNNE
Other - Middle Name:GARCIA
Other - Last Name:CANLAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:4445 W SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-6017
Mailing Address - Country:US
Mailing Address - Phone:323-668-2702
Mailing Address - Fax:
Practice Address - Street 1:4445 W SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90027-6017
Practice Address - Country:US
Practice Address - Phone:323-668-2702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-23
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15093152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist