Provider Demographics
NPI:1700537644
Name:SHENILA RAJANI OD INC
Entity Type:Organization
Organization Name:SHENILA RAJANI OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHENILA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJANI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:310-343-9322
Mailing Address - Street 1:1430 19TH ST
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-4031
Mailing Address - Country:US
Mailing Address - Phone:310-343-9322
Mailing Address - Fax:
Practice Address - Street 1:3471 WEST CENTURY BLVD
Practice Address - Street 2:C/O TARGET OPTICAL
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90303
Practice Address - Country:US
Practice Address - Phone:310-330-0180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-12
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty