Healthcare Provider Details

I. General information

NPI: 1467678656
Provider Name (Legal Business Name): MATTHEW JOHN ZOOLAKIS PHARM. D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7257 N FRESNO ST
FRESNO CA
93720-2950
US

IV. Provider business mailing address

1133 W LOS ALTOS AVE
FRESNO CA
93711-1471
US

V. Phone/Fax

Practice location:
  • Phone: 559-451-3632
  • Fax: 559-431-5827
Mailing address:
  • Phone: 559-451-3632
  • Fax: 559-431-5827

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number46318
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: