Provider Demographics
NPI:1447575477
Name:THROUGH THE HAYES OPTOMETRY
Entity Type:Organization
Organization Name:THROUGH THE HAYES OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:415-553-6166
Mailing Address - Street 1:529 HAYES ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-4213
Mailing Address - Country:US
Mailing Address - Phone:415-553-6166
Mailing Address - Fax:415-553-6168
Practice Address - Street 1:529 HAYES ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-4213
Practice Address - Country:US
Practice Address - Phone:415-553-6166
Practice Address - Fax:415-553-6168
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2012-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9464T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FY060AMedicare PIN