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NPI Code Detail

MEDICARE: DR. AMY THICH O.D.

MEDICARE:  DR. AMY  THICH  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist12365TCA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1134227325
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMY THICH O.D.
Provider Business Mailing Address
First Line : 1844 DIVISADERO ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-2517
Country : US
Telephone Number : 415-409-0888
Fax Number : 668-646-0388
Provider Business Practice Location Address
First Line : 1844 DIVISADERO ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-2517
Country : US
Telephone Number : 415-409-0888
Fax Number : 866-864-6038
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 06/10/2019

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Directions to “ DR. AMY THICH O.D.” Practice Location

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