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General NPI Number Information
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NPI Number | 1356759377
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Entity Type | Organization
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Legal Business Name | LASSA J. FRANK, OD, INC
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 1604 SIR FRANCIS DRAKE BLVD
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City | SAN ANSELMO
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State | CA
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Zip | 94960-1845
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Country | US
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Telephone | 415-453-8906
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Fax | 415-453-0156
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Provider Business Mailing Address
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Address Line | 1604 SIR FRANCIS DRAKE BLVD
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City | SAN ANSELMO
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State | CA
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Zip | 94960-1845
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Country | US
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Telephone | 415-453-8906
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Fax | 415-453-0156
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Authorized Official
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Title or Position | OWNER
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Name | DR. LASSA J FRANK
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Credential | OD
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Telephone | 415-453-8906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8464TPL
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License Number State | CA
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