Healthcare Provider Details

I. General information

NPI: 1811599046
Provider Name (Legal Business Name): DELMA F ZARDO OD A PROFESSIONAL OPTOMETRIC CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 STANDIFORD AVE STE 4
MODESTO CA
95350-0977
US

IV. Provider business mailing address

2421 KISKA DR
MODESTO CA
95355-7913
US

V. Phone/Fax

Practice location:
  • Phone: 209-524-7870
  • Fax: 209-524-7985
Mailing address:
  • Phone: 209-605-0442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. DELMA F ZARDO
Title or Position: OWNER
Credential: OD
Phone: 209-605-0442