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General NPI Number Information
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NPI Number | 1538984083
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Entity Type | Individual
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Provider Name | BRESHNA HABIBI OD
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Gender | Female
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Dates
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Enumeration Date | 11/19/2024
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 175 MARKET PL
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City | SAN RAMON
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State | CA
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Zip | 94583-4741
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Country | US
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Telephone | 925-275-0202
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Fax |
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Provider Business Mailing Address
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Address Line | 6038 LEDGEFERN CIR
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City | SAN RAMON
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State | CA
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Zip | 94582-9187
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Country | US
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Telephone | 925-502-7164
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 35243
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License Number State | CA
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