Provider Demographics
NPI:1033923602
Name:MARIAN MASOUD OD INC
Entity type:Organization
Organization Name:MARIAN MASOUD OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MASOUD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:562-682-5830
Mailing Address - Street 1:6902 E RENDINA ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4826
Mailing Address - Country:US
Mailing Address - Phone:562-682-5830
Mailing Address - Fax:
Practice Address - Street 1:28000 GREENSPOT RD
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-4450
Practice Address - Country:US
Practice Address - Phone:562-682-5830
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty