Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 152W00000X | Optometrist | OPT 12886 TPA | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | OPT 12886 TPA | CA |
N | 152WL0500X | Optomitrist - Low Vision Rehabilitation | OPT 12886 TPA | CA |
N | 152WP0200X | Pediatric Optomitrist | OPT12886 TPA | CA |
N | 152WX0102X | Occupational Vision | OPT 12886 TPA | CA |
NPI | 1154454395 |
---|---|
Provider Name | Mujda Zhublawar |
First Address | Hayward, CA 94541-3017 |
Second Address | Hayward, CA 94541-3017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2007 |
Last Update Date | 08/07/2007 |