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General NPI Number Information
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NPI Number | 1861833642
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Entity Type | Individual
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Provider Name | JIE TIAN NYON O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2013
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 3610 SACRAMENTO ST STE A
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City | SAN FRANCISCO
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State | CA
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Zip | 94118-1734
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Country | US
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Telephone | 415-673-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 95 BEHR AVE APT 103
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-1173
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Country | US
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Telephone | 626-226-9848
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Fax |
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | TUV008005-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14984
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License Number State | CA
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