MEDICARE: MONICA CHERNOGUZ O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	33530	CA

General Provider Information

NPI Number	:	1659724318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA CHERNOGUZ O.D.

Provider Business Mailing Address
First Line	:	305 24TH AVE
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94121-2001
Country	:	US
Telephone Number	:	415-254-2324
Fax Number	:

Provider Business Practice Location Address
First Line	:	1833 FILLMORE ST STE 100
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94115-3181
Country	:	US
Telephone Number	:	415-922-0660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2016
Last Update Date	:	08/18/2016

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