Healthcare Provider Details

I. General information

NPI: 1982993200
Provider Name (Legal Business Name): YALDO EYE CENTERS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2011
Last Update Date: 04/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24430 FORD RD
DEARBORN HEIGHTS MI
48127-3280
US

IV. Provider business mailing address

24430 FORD RD
DEARBORN HEIGHTS MI
48127-3280
US

V. Phone/Fax

Practice location:
  • Phone: 313-278-4540
  • Fax: 313-278-4541
Mailing address:
  • Phone: 313-278-4540
  • Fax: 313-278-4540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateMI

VIII. Authorized Official

Name: DR. MAZIN K YALDO
Title or Position: PRESIDENT
Credential: MD
Phone: 313-278-4540