Healthcare Provider Details

I. General information

NPI: 1952502593
Provider Name (Legal Business Name): MICHAEL ZIMRING OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

477 E COLORADO BLVD
PASADENA CA
91101-2024
US

IV. Provider business mailing address

11525 ROCHESTER AVE #102
LOS ANGELES CA
90025
US

V. Phone/Fax

Practice location:
  • Phone: 626-796-1191
  • Fax: 626-796-0189
Mailing address:
  • Phone: 310-478-6635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number5355T
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: