Livelo, Edith C
Livelo, Edith C is an sole proprietor health care provider with primary practice located at 21 S San Mateo Dr , San Mateo CA 94401-3803. She recently has only one registered license in Eye and Vision Services Providers / Optician, which is considered as her primary health care specialty. Livelo, Edith C can be contacted via phone (650) 343-5151.Contact Information
Primary practice address
21 S San Mateo Dr
San Mateo CA 94401-3803
Phone: (650) 343-5151
Fax: (650) 343-5178
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optician | 156FX1800X | D 6765 | California |
Profile Details
| NPI number | 1316010960 |
|---|---|
| LBN Legal business name | Livelo, Edith C |
| Credentials | ABOC, RDO |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1316010960 | NPPES |
| California | MEDICAID | DX006765F |
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