Organization
GLAUCOMA CONSULTANTS OF THE BAY AREA A MED CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARE F LIEBERMAN MD (OWNER)
(415) 771-4020
Entity
Organization
Contact information
Practice address
2211 POST STREET, SUITE 401, SAN FRANCISCO, CA 94115
(415) 771-4020
(415) 771-4095
Mailing address
2211 POST STREET, SUITE 401, SAN FRANCISCO, CA 94115
(415) 771-4020
(415) 771-4095
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G42547
CA
207W00000X
Ophthalmology Physician
G78526
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0099190
—
CA
01
—
ZZZ09878Z
BLUE SHIELD OF CA
—
Enumeration date
08/30/2006
Last updated
08/22/2020
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