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General NPI Number Information
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NPI Number | 1902076466
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Entity Type | Organization
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Legal Business Name | MARCIE ARNESTY-OLIAN, OD, A PROF CORP
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 06/19/2015
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Provider Practice Location Address
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Address Line | 37 BOVET RD
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City | SAN MATEO
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State | CA
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Zip | 94402-3104
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Country | US
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Telephone | 650-570-5955
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Fax | 650-570-7124
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Provider Business Mailing Address
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Address Line | 37 BOVET RD
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City | SAN MATEO
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State | CA
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Zip | 94402-3104
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Country | US
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Telephone | 650-570-5955
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Fax | 650-570-7124
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Authorized Official
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Title or Position | OWNER / OPTOMETRIST
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Name | MRS. MARCIE E ARNESTY-OLIAN
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Credential | O.D.
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Telephone | 650-570-5955
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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 | 7122T
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 7122T
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License Number State | CA
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