Provider Demographics
NPI:1780012807
Name:KATHLEEN HUM OD, A CALIFORNIA PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:KATHLEEN HUM OD, A CALIFORNIA PROFESSIONAL CORPORATION
Other - Org Name:CITY FOCUS OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUM
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:415-362-7707
Mailing Address - Street 1:500 SUTTER ST STE 508
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94102-1114
Mailing Address - Country:US
Mailing Address - Phone:415-362-7707
Mailing Address - Fax:415-362-9663
Practice Address - Street 1:500 SUTTER ST STE 508
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94102-1114
Practice Address - Country:US
Practice Address - Phone:415-362-7707
Practice Address - Fax:415-362-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-29
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA 8253T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty