Provider Demographics
NPI:1497118749
Name:RAHUL R. SUD, OD
Entity Type:Organization
Organization Name:RAHUL R. SUD, OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:RAHUL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SUD
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:706-631-5686
Mailing Address - Street 1:2100 UNION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4004
Mailing Address - Country:US
Mailing Address - Phone:415-561-9948
Mailing Address - Fax:
Practice Address - Street 1:2100 UNION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4004
Practice Address - Country:US
Practice Address - Phone:415-561-9948
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-04
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15451TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty