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General NPI Number Information
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NPI Number | 1043424781
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Entity Type | Organization
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Legal Business Name | RAYNA PISKOVA MD INC
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 509 S I ST SUITE C
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City | MADERA
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State | CA
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Zip | 93637-4660
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Country | US
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Telephone | 559-675-1715
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Fax |
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Provider Business Mailing Address
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Address Line | 509 S I ST SUITE C
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City | MADERA
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State | CA
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Zip | 93637-4660
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Country | US
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Telephone | 559-675-1715
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAYNA PISKOVA
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Credential | M.D.
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Telephone | 661-869-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | A52376
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | A52376
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | A52376
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License Number State | CA
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