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General NPI Number Information
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NPI Number | 1811835150
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Entity Type | Individual
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Provider Name | MANSOOR SHAFQAT ABOC, NCLEC, LDO
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Gender | Male
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Dates
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Enumeration Date | 03/24/2026
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Last Update Date | 03/24/2026
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Provider Practice Location Address
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Address Line | 1 SHIELDS AVE
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City | DAVIS
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State | CA
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Zip | 95616-8500
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Country | US
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Telephone | 530-752-3324
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Fax | 530-752-4252
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Provider Business Mailing Address
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Address Line | 907 BOURN DR SPC 24
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City | WOODLAND
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State | CA
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Zip | 95776-9304
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Country | US
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Telephone | 530-752-3324
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Fax | 530-752-4252
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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 | 156FC0800X
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Taxonomy Name | Contact Lens Technician/Technologist
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License Number | 2265
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number | 6053
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License Number State | CA
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