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NPI Code Detail

MEDICARE: DR. SOPHIA MOH OD

MEDICARE: DR. SOPHIA MOH OD
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
1152W00000XOptometrist35164TLGCA

General Provider Information

NPI Number : 1487372629
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SOPHIA MOH OD
Provider Business Mailing Address
First Line : 36 MATEO AVE
Second Line :
City : DALY CITY
State : CA
Zip : 94014-2406
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 950 CODDINGTOWN CTR
Second Line :
City : SANTA ROSA
State : CA
Zip : 95401-3512
Country : US
Telephone Number : 707-528-3876
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2022
Last Update Date : 02/02/2026

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