Provider Demographics
NPI:1700210242
Name:ABDALI, NAHID (OD)
Entity Type:Individual
Prefix:DR
First Name:NAHID
Middle Name:
Last Name:ABDALI
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 1:5801 NORRIS CANYON RD
Mailing Address - Street 2:SUITE #200
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-5440
Mailing Address - Country:US
Mailing Address - Phone:925-830-8823
Mailing Address - Fax:
Practice Address - Street 1:5801 NORRIS CANYON RD
Practice Address - Street 2:SUITE #200
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-5440
Practice Address - Country:US
Practice Address - Phone:925-830-8823
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-31
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14761 TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist