Provider Demographics
NPI:1578669560
Name:EYECARE ASSOCIATES OF SAN FRANCISCO, A MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:EYECARE ASSOCIATES OF SAN FRANCISCO, A MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:S
Authorized Official - Middle Name:SAMUEL
Authorized Official - Last Name:GELBART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-982-2020
Mailing Address - Street 1:490 POST ST
Mailing Address - Street 2:SUIT 640
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1401
Mailing Address - Country:US
Mailing Address - Phone:415-982-2020
Mailing Address - Fax:415-982-2011
Practice Address - Street 1:490 POST ST
Practice Address - Street 2:SUIT 640
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1401
Practice Address - Country:US
Practice Address - Phone:415-982-2020
Practice Address - Fax:415-982-2011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA89693Medicare UPIN
CAA41161Medicare UPIN
CAU78302Medicare UPIN
CAH70343Medicare UPIN