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General NPI Number Information
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NPI Number | 1437677531
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Entity Type | Organization
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Legal Business Name | OPTICA OPTOMETRY CORPORATION
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Dates
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Enumeration Date | 09/08/2017
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Last Update Date | 11/14/2017
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Provider Practice Location Address
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Address Line | 199A TAYLOR BOULEVARD
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City | MILLBRAE
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State | CA
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Zip | 94030
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Country | US
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Telephone | 650-826-2020
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Fax | 650-826-2020
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Provider Business Mailing Address
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Address Line | 699 ABBOT AVE
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City | DALY CITY
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State | CA
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Zip | 94014-2770
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER/OPTOMETRIST
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Name | DR. MARIANNE FLORENDO
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Credential | OD
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Telephone | 650-533-2814
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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 |
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License Number State |
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