Healthcare Provider Details

I. General information

NPI: 1306952395
Provider Name (Legal Business Name): FELIX SHRAYBER ABOC, NCLEC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2527 MISSION ST
SAN FRANCISCO CA
94110-2511
US

IV. Provider business mailing address

2527 MISSION ST
SAN FRANCISCO CA
94110-2511
US

V. Phone/Fax

Practice location:
  • Phone: 415-285-1444
  • Fax: 415-285-1445
Mailing address:
  • Phone: 415-285-1444
  • Fax: 415-285-1445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License NumberD 5648
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: