Provider Demographics
NPI:1649762014
Name:HASHEMI OPHTHALMOLOGY, PC
Entity type:Organization
Organization Name:HASHEMI OPHTHALMOLOGY, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NAFISEH
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHEMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-387-6565
Mailing Address - Street 1:5353 BALBOA BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-2859
Mailing Address - Country:US
Mailing Address - Phone:818-387-6565
Mailing Address - Fax:818-387-6288
Practice Address - Street 1:5353 BALBOA BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316
Practice Address - Country:US
Practice Address - Phone:818-387-6565
Practice Address - Fax:818-387-6288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA136366207WX0109X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207WX0109XAllopathic & Osteopathic PhysiciansOphthalmologyNeuro-ophthalmologyGroup - Multi-Specialty