Healthcare Provider Details

I. General information

NPI: 1033227665
Provider Name (Legal Business Name): KAUSER V SHARIEFF O.D. FCOVD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 11/16/2020
Certification Date: 11/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17674 YORBA LINDA BLVD
YORBA LINDA CA
92886-3927
US

IV. Provider business mailing address

17674 YORBA LINDA BLVD
YORBA LINDA CA
92886-3927
US

V. Phone/Fax

Practice location:
  • Phone: 714-996-6210
  • Fax: 714-996-6212
Mailing address:
  • Phone: 714-996-6210
  • Fax: 714-996-6212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number10527
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number10527
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number10527TPL
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number10527
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number10527
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number10527
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: