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Organization
LARKSPUR LANDING OPTOMETRIC CORPORATION
Active
Organization
LARKSPUR LANDING OPTOMETRIC CORPORATION
Active
Other names
Larkspur Landing Optometry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD IAN HAACK O.D. (OWNER)
(415) 925-9091
Entity
Organization
Contact information
Practice address
2005 LARKSPUR LANDING CIR, LARKSPUR, CA 94939-1802
(415) 925-9091
(415) 925-9092
Mailing address
2005 LARKSPUR LANDING CIR, LARKSPUR, CA 94939-1802
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
10226T
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174516462
NPI
CA
01
—
1972725760
NPI
CA
Enumeration date
01/15/2009
Last updated
11/18/2010
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