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General NPI Number Information
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NPI Number | 1932112612
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Entity Type | Individual
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Provider Name | ELSA T PAO OD
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Gender | Female
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Dates
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Enumeration Date | 08/14/2006
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 901 FRANKLIN ST #68
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City | OAKLAND
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State | CA
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Zip | 94607-4472
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Country | US
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Telephone | 650-278-6501
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Fax |
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Provider Business Mailing Address
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Address Line | 901 FRANKLIN ST STE 68
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City | OAKLAND
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State | CA
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Zip | 94607-4476
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Country | US
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Telephone | 510-238-9797
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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 | 10522
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License Number State | CA
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