| Dr Tariq Tahir Khraishi, OD | |
|
317 W Pacific Coast Hwy Ste B, Wilmington, CA 90744-2542 | |
| (424) 264-5821 | |
| (424) 264-5886 |
| Full Name | Dr Tariq Tahir Khraishi |
|---|---|
| Gender | Male |
| Speciality | Optometrist |
| Location | 317 W Pacific Coast Hwy Ste B, Wilmington, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205878634 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 12311T (California) | Primary |
| Provider Name | Dr Terrry Khraishi Od Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1043879000 PECOS PAC ID: 8426479510 Enrollment ID: O20200527002496 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Tariq Tahir Khraishi, OD 1907 Dufour Ave Unit B, Redondo Beach, CA 90278-1307 Ph: (310) 864-9323 | Dr Tariq Tahir Khraishi, OD 317 W Pacific Coast Hwy Ste B, Wilmington, CA 90744-2542 Ph: (424) 264-5821 |
Dr. Terrry Khraishi Od Inc Optometrist Medicare: Medicare Enrolled Practice Location: 317 W Pacific Coast Hwy Ste B, Wilmington, CA 90744 Phone: 424-264-5821 Fax: 424-264-5821 | |
Richard M Peters Od An Optometric Corporation Optometrist Medicare: Not Enrolled in Medicare Practice Location: 810 N Avalon Blvd, Wilmington, CA 90744 Phone: 310-834-5464 Fax: 310-835-6665 | |
Brandon Luu Od, Inc. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 810 N Avalon Blvd, Wilmington, CA 90744 Phone: 310-834-5464 Fax: 714-229-1994 | |
Dr. Richard M Peters, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 810 N Avalon Blvd, Wilmington, CA 90744 Phone: 310-834-5464 Fax: 310-835-6665 |