Provider Demographics
NPI:1053549220
Name:PASARI, SHRUTI (OD)
Entity type:Individual
Prefix:DR
First Name:SHRUTI
Middle Name:
Last Name:PASARI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17291 IRVINE BLVD STE 251
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2930
Mailing Address - Country:US
Mailing Address - Phone:714-731-4771
Mailing Address - Fax:
Practice Address - Street 1:563 NEWPORT CENTER DR
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-6937
Practice Address - Country:US
Practice Address - Phone:949-301-8001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-26
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11314T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist