Provider Demographics
NPI:1033794201
Name:KAKAR, MURED (ABO)
Entity Type:Individual
Prefix:MR
First Name:MURED
Middle Name:
Last Name:KAKAR
Suffix:
Gender:M
Credentials:ABO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:970 MEADOWSWEET DR
Mailing Address - Street 2:
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1721
Mailing Address - Country:US
Mailing Address - Phone:415-573-9592
Mailing Address - Fax:
Practice Address - Street 1:611 SAN ANSELMO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-2615
Practice Address - Country:US
Practice Address - Phone:415-747-8191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41845156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician