| Eyedentity Vision Optometry | |
|
2786 Diamond St San Francisco CA 94131-3057 | |
| (415) 334-2020 | |
| (415) 681-9268 |
| Full Name | Eyedentity Vision Optometry |
|---|---|
| Speciality | Clinic/Center |
| Location | 2786 Diamond St, San Francisco, California |
| Authorized Official Name and Position | Carrie Lee (PRESIDENT) |
| Authorized Official Contact | 4153342020 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eyedentity Vision Optometry 2786 Diamond St San Francisco CA 94131-3057 Ph: (415) 334-2020 | Eyedentity Vision Optometry 2786 Diamond St San Francisco CA 94131-3057 Ph: (415) 334-2020 |
| NPI Number | 1255514642 |
|---|---|
| Provider Enumeration Date | 12/09/2007 |
| Last Update Date | 10/11/2021 |
| Medicare PECOS PAC ID | 4385723725 |
|---|---|
| Medicare Enrollment ID | O20080509000271 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255514642 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 12604 (California) | Primary |
| Provider Name | Carrie Lee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760474142 PECOS PAC ID: 3375523848 Enrollment ID: I20040723001054 |
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