Individual
JENNIFER EDITH DE NIRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
491 30TH ST STE 201, OAKLAND, CA 94609-3235
(510) 836-2122
(510) 836-3773
Mailing address
491 30TH ST STE 201, OAKLAND, CA 94609-3235
(510) 836-2122
(510) 836-3773
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A115886
CA
207WX0009X
Glaucoma Specialist (Ophthalmology) Physician
A115886
CA
Other
Enumeration date
10/19/2010
Last updated
07/18/2019
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