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Contact Information

PEYAM MOJALLAL, OD
20600 GORDON PARK SQ
SUITE 150
ASHBURN, VA20147-3145
 Phone: 703-723-3433
 Fax: 703-723-1920
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Low Vision Rehabilitation

152WL0500X 41 Optometry
 

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for PEYAM MOJALLAL · (Male)

NPI Number 1154378511
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 05/30/2006
Last updated 12/06/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • VA License # 0618001051
  • VA Medicaid 9236805
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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