Active NPI
Tenie Avanessian
- Optometrist
- Los Angeles, CA
National Provider Identifier
1548982853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 35209
- Practice address
- 1059 Gayley Ave
Los Angeles, CA 90024-3401 - Phone
- (310) 208-3011
- NPI assigned
- Sep 13, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 35209 | CA | Primary |
Addresses
Primary practice location
1059 Gayley Ave
Los Angeles, CA 90024-3401
Mailing address
1631 Santa Barbara Ave
Glendale, CA 91208-2020
Phone (818) 216-9866
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1663027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1548982853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1631 SANTA BARBARA AVE",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912082020",
"telephone_number": "818-216-9866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1059 GAYLEY AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900243401",
"telephone_number": "310-208-3011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AVANESSIAN",
"first_name": "TENIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-09-13",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "35209",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.