Provider Demographics
NPI:1710950456
Name:CHAR, DEVRON HENRY (MD)
Entity Type:Individual
Prefix:DR
First Name:DEVRON
Middle Name:HENRY
Last Name:CHAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:45 CASTRO ST
Mailing Address - Street 2:#309
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114
Mailing Address - Country:US
Mailing Address - Phone:415-522-0700
Mailing Address - Fax:415-522-0723
Practice Address - Street 1:45 CASTRO ST
Practice Address - Street 2:#309
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114
Practice Address - Country:US
Practice Address - Phone:415-522-0700
Practice Address - Fax:415-522-0723
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-13
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAC35585207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA8960132Medicaid
CA00C355850Medicare PIN
CA8960132Medicaid