Individual
EDITH C LIVELO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ABOC, RDO
Contact information
Practice address
21 S SAN MATEO DR, SAN MATEO, CA 94401-3803
(650) 343-5151
(650) 343-5178
Mailing address
21 S SAN MATEO DR, SAN MATEO, CA 94401-3803
(650) 343-5151
(650) 343-5178
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
D 6765
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DX006765F
—
CA
Enumeration date
11/15/2006
Last updated
07/08/2007
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