Provider Demographics
NPI:1164503678
Name:GEFFEN, DAVID I (OD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:I
Last Name:GEFFEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8910 UNIVERSITY CENTER LN
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-1031
Mailing Address - Country:US
Mailing Address - Phone:858-455-6800
Mailing Address - Fax:858-455-0244
Practice Address - Street 1:8910 UNIVERSITY CENTER LN
Practice Address - Street 2:SUITE 800
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-1031
Practice Address - Country:US
Practice Address - Phone:858-455-6800
Practice Address - Fax:858-455-0244
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA7467152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAT70202Medicare UPIN
CAOP7467CMedicare ID - Type Unspecified