Glaucoma Consultants of the Bay Area a Med Corp

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

G42547 Issued in CA

Legal business name

GLAUCOMA CONSULTANTS OF THE BAY AREA A MED CORP

Practice address

2211 Post Street
Suite 401
San Francisco, CA 94115

Phone

(415) 771-4020

Fax

(415) 771-4095

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mare F Lieberman, MD

Title

Owner

Phone

(415) 771-4020

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952411050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 POST STREET",
            "address_2": "SUITE 401",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94115",
            "telephone_number": "415-771-4020",
            "fax_number": "415-771-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 POST STREET",
            "address_2": "SUITE 401",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "94115",
            "telephone_number": "415-771-4020",
            "fax_number": "415-771-4095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAUCOMA CONSULTANTS OF THE BAY AREA A MED CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "MARE",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "415-771-4020",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G42547",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G78526",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ09878Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0099190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dax Glasson-Darling, LCSW, MT-BC
• Christine M. Glastonbury, MB, BS
• Olivia Glatt, MD
• Shulamit Glaubach, M.D.
• Adam Nathaniel Glauberg
• Rose Glavin, L.AC
• Jacob Glazebnik
• Aaron Gleason
• Jill Elizabeth Gleason, PT
• Madeline Ann Gleason

• Ophthalmology Physician in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Ophthalmology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.