Provider Demographics
NPI:1114073483
Name:STERN, VICTOR N (OD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:N
Last Name:STERN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1635 DIVISADERO ST
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3036
Mailing Address - Country:US
Mailing Address - Phone:415-833-3959
Mailing Address - Fax:415-833-2609
Practice Address - Street 1:1635 DIVISADERO ST
Practice Address - Street 2:SUITE 400A
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3036
Practice Address - Country:US
Practice Address - Phone:415-833-3959
Practice Address - Fax:415-833-2609
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5216T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist