MEDICARE: DR. USHA HARI 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	10951T	CA

General Provider Information

NPI Number	:	1891842399
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. USHA HARI O.D.

Provider Business Mailing Address
First Line	:	PO BOX 928215
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92192-8215
Country	:	US
Telephone Number	:	858-232-7537
Fax Number	:

Provider Business Practice Location Address
First Line	:	3412 COLLEGE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-7134
Country	:	US
Telephone Number	:	619-286-1291
Fax Number	:

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

Provider Enumeration Date	:	01/05/2007
Last Update Date	:	07/08/2007

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