Provider Demographics
NPI:1366507212
Name:VIPUL, FAIZA DOSSA (OD)
Entity Type:Individual
Prefix:
First Name:FAIZA
Middle Name:DOSSA
Last Name:VIPUL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:FAIZA
Other - Middle Name:
Other - Last Name:DOSSA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1799 4TH ST STE E
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-1741
Mailing Address - Country:US
Mailing Address - Phone:510-559-8181
Mailing Address - Fax:510-559-9581
Practice Address - Street 1:900 BUSH ST
Practice Address - Street 2:220
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94109-8714
Practice Address - Country:US
Practice Address - Phone:415-609-6796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12922152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist