Provider Demographics
NPI:1356759377
Name:LASSA J. FRANK, OD, INC
Entity type:Organization
Organization Name:LASSA J. FRANK, OD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LASSA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FRANK
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:415-453-8906
Mailing Address - Street 1:1604 SIR FRANCIS DRAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN ANSELMO
Mailing Address - State:CA
Mailing Address - Zip Code:94960-1845
Mailing Address - Country:US
Mailing Address - Phone:415-453-8906
Mailing Address - Fax:415-453-0156
Practice Address - Street 1:1604 SIR FRANCIS DRAKE BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANSELMO
Practice Address - State:CA
Practice Address - Zip Code:94960-1845
Practice Address - Country:US
Practice Address - Phone:415-453-8906
Practice Address - Fax:415-453-0156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA8464TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty