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General NPI Number Information
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NPI Number | 1235552951
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Entity Type | Organization
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Legal Business Name | DALY CITY OPTOMETRY, A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 01/31/2014
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Last Update Date | 12/03/2015
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Provider Practice Location Address
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Address Line | 94B SERRAMONTE CTR
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City | DALY CITY
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State | CA
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Zip | 94015-2345
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Country | US
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Telephone | 650-756-4000
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Fax | 650-756-4070
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Provider Business Mailing Address
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Address Line | 94B SERRAMONTE CTR
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City | DALY CITY
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State | CA
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Zip | 94015-2345
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Country | US
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Telephone | 650-756-4000
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Fax | 650-756-4070
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Authorized Official
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Title or Position | SECRETARY
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Name | MISS CELESTE A PAZ
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Credential | O.D.
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Telephone | 510-304-3091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | OPT 9510 TPA
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | OPT 7752 TPL
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT 12465 TPL
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License Number State | CA
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