Provider Demographics
NPI:1467855775
Name:SAN FRANCISCO OCULOFACIAL PLASTIC SURGERY, P.C.
Entity type:Organization
Organization Name:SAN FRANCISCO OCULOFACIAL PLASTIC SURGERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KASRA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELIASIEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-799-8800
Mailing Address - Street 1:2186 GEARY BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3456
Mailing Address - Country:US
Mailing Address - Phone:415-799-8800
Mailing Address - Fax:
Practice Address - Street 1:2186 GEARY BLVD STE 212
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3456
Practice Address - Country:US
Practice Address - Phone:415-799-8800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA132513207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty