# GLAUCOMA CONSULTANTS OF THE BAY AREA A MED CORP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952411050
- **Authorized official:** MR. MARE F LIEBERMAN MD (OWNER)
- **Authorized official phone:** (415) 771-4020

## Contact information

- **Practice address:** 2211 POST STREET, SUITE 401, SAN FRANCISCO, CA 94115
- **Practice address phone:** (415) 771-4020
- **Practice address fax:** (415) 771-4095
- **Mailing address:** 2211 POST STREET, SUITE 401, SAN FRANCISCO, CA 94115
- **Mailing address phone:** (415) 771-4020
- **Mailing address fax:** (415) 771-4095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | G42547 | CA | Yes |
| 207W00000X | Ophthalmology Physician | G78526 | CA | — |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GR0099190 | — | CA |
| 01 | — | ZZZ09878Z | BLUE SHIELD OF CA | — |