Provider Demographics
NPI:1598814527
Name:AZUS, ALICE NG (OD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:NG
Last Name:AZUS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ALICE
Other - Middle Name:
Other - Last Name:NG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:287 BELLA VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1811
Mailing Address - Country:US
Mailing Address - Phone:415-239-0639
Mailing Address - Fax:
Practice Address - Street 1:395 HICKEY BLVD
Practice Address - Street 2:
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015-2770
Practice Address - Country:US
Practice Address - Phone:650-301-5800
Practice Address - Fax:650-301-5802
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8820-T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist