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General NPI Number Information
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NPI Number | 1861407223
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Entity Type | Organization
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Legal Business Name | A. W. MEYER, OPTOMETRIST
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 94 SERRAMONTE CTR # B
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City | DALY CITY
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State | CA
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Zip | 94015-2345
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Country | US
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Telephone | 650-992-8007
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Fax |
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Provider Business Mailing Address
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Address Line | 94 SERRAMONTE CTR # B
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City | DALY CITY
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State | CA
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Zip | 94015-2345
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Country | US
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Telephone | 650-992-8007
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID CAMERON BROSNAN
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Credential | O.D.
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Telephone | 650-992-8007
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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 | 11410T
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License Number State | CA
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