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General NPI Number Information
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NPI Number | 1619416112
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Entity Type | Organization
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Legal Business Name | DR. MONETTA OD
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Dates
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Enumeration Date | 02/16/2017
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Last Update Date | 06/20/2017
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Provider Practice Location Address
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Address Line | 2532 OCEAN AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1614
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Country | US
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Telephone | 415-239-2544
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Fax | 415-239-1994
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Provider Business Mailing Address
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Address Line | 2532 OCEAN AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94132-1614
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Country | US
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Telephone | 415-239-2544
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Fax | 415-239-1994
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Authorized Official
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Title or Position | CEO/OWNER
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Name | ROBERT MONETTA
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Credential | OD
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Telephone | 415-239-2544
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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 | 7529T
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License Number State | CA
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