Healthcare Provider Details

I. General information

NPI: 1124153853
Provider Name (Legal Business Name): ROBERT STEPHEN MCGARVEY O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 SERRAMONTE CTR
DALY CITY CA
94015-2345
US

IV. Provider business mailing address

1340 CAYUGA AVE
SAN FRANCISCO CA
94112-3356
US

V. Phone/Fax

Practice location:
  • Phone: 650-992-8404
  • Fax: 650-992-6782
Mailing address:
  • Phone: 415-585-7467
  • Fax: 415-585-7467

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOPT8282
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: