Provider Demographics
NPI:1154454395
Name:ZHUBLAWAR, MUJDA (OD)
Entity type:Individual
Prefix:
First Name:MUJDA
Middle Name:
Last Name:ZHUBLAWAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1575 B ST
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-3017
Mailing Address - Country:US
Mailing Address - Phone:510-581-1430
Mailing Address - Fax:510-581-7368
Practice Address - Street 1:1575 B ST
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-3017
Practice Address - Country:US
Practice Address - Phone:510-581-1430
Practice Address - Fax:510-581-7368
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT 12886 TPA152W00000X, 152WC0802X, 152WL0500X, 152WX0102X
CAOPT12886 TPA152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered152W00000XEye and Vision Services ProvidersOptometrist
Not Answered152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Not Answered152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Not Answered152WP0200XEye and Vision Services ProvidersOptometristPediatrics
Not Answered152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision