Provider Demographics
NPI:1306952395
Name:SHRAYBER, FELIX (ABOC, NCLEC)
Entity type:Individual
Prefix:MR
First Name:FELIX
Middle Name:
Last Name:SHRAYBER
Suffix:
Gender:M
Credentials:ABOC, NCLEC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2527 MISSION ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2511
Mailing Address - Country:US
Mailing Address - Phone:415-285-1444
Mailing Address - Fax:415-285-1445
Practice Address - Street 1:2527 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2511
Practice Address - Country:US
Practice Address - Phone:415-285-1444
Practice Address - Fax:415-285-1445
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD 5648156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADX005648FMedicaid