Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 12572T | CA |
NPI | 1003955444 |
---|---|
Provider Name | Melanie Feliciano |
First Address | Foster City, CA 94404-2300 |
Second Address | Foster City, CA 94404-2300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2007 |
Last Update Date | 16/07/2012 |