Provider Demographics
NPI:1629133590
Name:FENG, VICTORIA C (OD)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:C
Last Name:FENG
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 WILDE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94134-2251
Mailing Address - Country:US
Mailing Address - Phone:650-452-3936
Mailing Address - Fax:415-399-1960
Practice Address - Street 1:100 BATTERY ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94111-4903
Practice Address - Country:US
Practice Address - Phone:415-399-1473
Practice Address - Fax:415-399-1960
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12878152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist