Individual provider Active NPI

Bernard Joseph Dolan, O.D.

  • Optometrist
  • San Francisco, CA
National Provider Identifier
1912017179
Registry record updated Jul 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2065 Issued in WA
Practice address
4150 Clement St
Eye Clinic 112-a
San Francisco, CA 94121-1545
Phone
(415) 221-4810
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2065 WA Primary

Addresses

Primary practice location

4150 Clement St
Eye Clinic 112-a
San Francisco, CA 94121-1545

Mailing address

4150 Clement St
Eye Clinic 112-a
San Francisco, CA 94121-1545
Phone (415) 221-4810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2065WAMDOptometrist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184630400000",
    "number": "1912017179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "address_2": "EYE CLINIC 112-A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211545",
            "telephone_number": "415-221-4810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 CLEMENT ST",
            "address_2": "EYE CLINIC 112-A",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941211545",
            "telephone_number": "415-221-4810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOLAN",
        "first_name": "BERNARD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WA",
            "license": "2065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.