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General NPI Number Information
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NPI Number | 1679218671
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Entity Type | Organization
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Legal Business Name | VERISSA LAM OPTOMETRY CORPORATION
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 100 BATTERY ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-4903
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Country | US
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Telephone | 415-399-1773
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Fax | 415-335-4373
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Provider Business Mailing Address
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Address Line | 100 BATTERY ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-4903
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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 | VERRISSA LAM FONG
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Credential | OD
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Telephone | 415-399-1773
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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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