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General NPI Number Information
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NPI Number | 1720890411
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Entity Type | Organization
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Legal Business Name | ALEXANDER DAAS RETAIL V, INC.
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Dates
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Enumeration Date | 01/21/2025
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 855 EL CAMINO REAL STE 103
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City | PALO ALTO
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State | CA
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Zip | 94301-2335
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Country | US
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Telephone | 650-326-9111
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 280
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City | DEL MAR
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State | CA
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Zip | 92014-0280
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Country | US
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Telephone | 415-614-0259
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALEXANDER FELDMAN
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Credential | DO
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Telephone | 415-614-0259
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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