Healthcare Provider Details

I. General information

NPI: 1730265141
Provider Name (Legal Business Name): GEORGE PETER CONTOS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 12/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 E CALAVERAS BLVD
MILPITAS CA
95035-5412
US

IV. Provider business mailing address

410 ESCOBAR ST
FREMONT CA
94539-5713
US

V. Phone/Fax

Practice location:
  • Phone: 408-262-4178
  • Fax: 408-262-5351
Mailing address:
  • Phone: 510-789-7053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number6424 T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: