| Doctor Name: | DR. ANGELA KHAKSHOOY |
| NPI Number: | 1013247212 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | O.D. |
| License Number: | 13893 |
| Business Practice Address: | 425 W Bonita Ave Ste 110b San Dimas, CA - 917732543 |
| Business Phone Number: | 9093940462 |
| Business Fax Number: | 9093940014 |
| Mailing Address: | 425 W Bonita Ave Ste 110b, SAN DIMAS |
| State: | CA |
| Postal Code: | 917732543 |
| Phone Number: | 9093940462 |
| Fax Number: | 9093940014 |
| NPI Enumeration Date: | 01/11/2010 |
| NPI Last Update Date: | 05/24/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | 13893 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |