Healthcare Provider Details

I. General information

NPI: 1013204684
Provider Name (Legal Business Name): DORA G SZYMANOWICZ NAGY O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DORA G SZYMANOWICZ O.D.

II. Dates (important events)

Enumeration Date: 07/05/2011
Last Update Date: 01/09/2022
Certification Date: 01/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11260 WHITE ROCK RD
RANCHO CORDOVA CA
95742
US

IV. Provider business mailing address

11260 WHITE ROCK RD
RANCHO CORDOVA CA
95742
US

V. Phone/Fax

Practice location:
  • Phone: 916-724-2265
  • Fax:
Mailing address:
  • Phone: 916-724-2265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License NumberTUV007714
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number14889TLG
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: