Provider Demographics
NPI:1497953111
Name:ELIOT KAPLAN O D INC
Entity Type:Organization
Organization Name:ELIOT KAPLAN O D INC
Other - Org Name:MILL VALLEY OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:ELIOT
Authorized Official - Last Name:KAPLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-381-2020
Mailing Address - Street 1:61 CAMINO ALTO STE 100
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2900
Mailing Address - Country:US
Mailing Address - Phone:415-381-2020
Mailing Address - Fax:
Practice Address - Street 1:61 CAMINO ALTO STE 100
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2900
Practice Address - Country:US
Practice Address - Phone:415-381-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2023-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6475152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1070230001Medicare NSC
ZZZ25967ZMedicare PIN