Healthcare Provider Details

I. General information

NPI: 1295381507
Provider Name (Legal Business Name): NEETY KOCHAR OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 08/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BATTERY ST
SAN FRANCISCO CA
94111-4903
US

IV. Provider business mailing address

400 BEALE ST APT 304
SAN FRANCISCO CA
94105-4409
US

V. Phone/Fax

Practice location:
  • Phone: 415-399-1473
  • Fax:
Mailing address:
  • Phone: 415-872-2052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number34293TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: