Provider Demographics
NPI:1245986439
Name:ATOUSA ATTAR OD INC
Entity type:Organization
Organization Name:ATOUSA ATTAR OD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:ATOUSA
Authorized Official - Middle Name:
Authorized Official - Last Name:ATTAR
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-278-9707
Mailing Address - Street 1:22 VILLAMOURA
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-8948
Mailing Address - Country:US
Mailing Address - Phone:949-278-9707
Mailing Address - Fax:
Practice Address - Street 1:300 SHOPS BLVD
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-347-1287
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-25
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty