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General NPI Number Information
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NPI Number | 1568857290
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Entity Type | Organization
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Legal Business Name | LOOP OPTOMETRY
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 03/31/2015
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Provider Practice Location Address
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Address Line | 252 5TH STREET
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City | SAN FRANCISCO
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State | CA
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Zip | 94107
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Country | US
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Telephone | 415-823-3637
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Fax |
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Provider Business Mailing Address
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Address Line | 1435 41ST AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94122-3033
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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 | PRESIDENT
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Name | MAY SZETO
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Credential | O.D.
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Telephone | 415-823-3637
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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 | OPT13775TLG
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License Number State | CA
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