Provider Demographics
NPI:1841019734
Name:CHHABRA, TALISA (OD)
Entity type:Individual
Prefix:DR
First Name:TALISA
Middle Name:
Last Name:CHHABRA
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 1:27420 TOURNEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27420 TOURNEY RD STE 100
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5631
Practice Address - Country:US
Practice Address - Phone:661-259-3937
Practice Address - Fax:661-259-3904
Is Sole Proprietor?:No
Enumeration Date:2024-10-08
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35861152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist