Provider Demographics
NPI:1740331057
Name:PAREKH, MINITA ARVIN (OD)
Entity type:Individual
Prefix:
First Name:MINITA
Middle Name:ARVIN
Last Name:PAREKH
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 1:7077 CRYSTALLINE DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-3968
Mailing Address - Country:US
Mailing Address - Phone:760-930-0464
Mailing Address - Fax:
Practice Address - Street 1:7007 FRIARS RD
Practice Address - Street 2:FASHION VALLEY CENTER #720
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1148
Practice Address - Country:US
Practice Address - Phone:619-683-5550
Practice Address - Fax:619-683-5555
Is Sole Proprietor?:No
Enumeration Date:2007-01-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12638152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWOP12638Medicare ID - Type Unspecified
CAV01404Medicare UPIN