Individual
JANE POUVARANUKOAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4150 CLEMENT ST, SAN FRANCISCO, CA 94121-1563
(415) 221-4810
Mailing address
772 N GARFIELD AVE APT 103, MONTEBELLO, CA 90640-1664
(323) 712-3672
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
ODP-100404
ID
Other
Enumeration date
06/27/2017
Last updated
12/06/2021
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