Healthcare Provider Details

I. General information

NPI: 1174169767
Provider Name (Legal Business Name): ZUNIGA OPTICAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2019
Last Update Date: 11/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 MAIN ST
NAPA CA
94559-3381
US

IV. Provider business mailing address

PO BOX 6614
NAPA CA
94581-1614
US

V. Phone/Fax

Practice location:
  • Phone: 707-332-0507
  • Fax:
Mailing address:
  • Phone: 707-332-0507
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code156FX1800X
TaxonomyOptician
License Number
License Number State

VIII. Authorized Official

Name: MARIA ESTHER ZUNIGA VAZQUEZ
Title or Position: REGISTER DISPENSING OPTICIAN
Credential: ABOC/RDO
Phone: 707-332-0507