| |
37 Bovet Rd, San Mateo, CA 94402-3104 | |
(650) 570-5955 | |
(650) 570-7124 |
Full Name | |
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Type | Facility |
Speciality | Eyewear Supplier |
Location | 37 Bovet Rd, San Mateo, California |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1902076466 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 7122T (California) | Secondary |
332H00000X | Eyewear Supplier | 7122T (California) | Primary |
Provider Name | Marcie E Arnesty |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1427103787 PECOS PAC ID: 8921292129 Enrollment ID: I20101102000286 |
Provider Name | Terri Justine Mark |
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Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1871649202 PECOS PAC ID: 1456665918 Enrollment ID: I20150729007258 |
Mailing Address | Practice Location Address |
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37 Bovet Rd, San Mateo, CA 94402-3104 Ph: (650) 570-5955 | 37 Bovet Rd, San Mateo, CA 94402-3104 Ph: (650) 570-5955 |