MEDICARE: JOY MASAKO OHARA 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	7648T	TX
2	152W00000X	Optometrist	14850TLG	CA

General Provider Information

NPI Number	:	1780992610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOY MASAKO OHARA O.D.

Provider Business Mailing Address
First Line	:	711 VAN NESS AVE
Second Line	:	SUITE 300
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-3244
Country	:	US
Telephone Number	:	415-567-8200
Fax Number	:	415-567-2973

Provider Business Practice Location Address
First Line	:	711 VAN NESS AVE
Second Line	:	SUITE 300
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94102-3244
Country	:	US
Telephone Number	:	415-567-8200
Fax Number	:	415-567-2973

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

Provider Enumeration Date	:	09/14/2010
Last Update Date	:	01/31/2017

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