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General NPI Number Information
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NPI Number | 1215718804
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Entity Type | Individual
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Provider Name | KYRILLOS ZAKI OD
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Gender | Male
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Dates
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Enumeration Date | 10/10/2023
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Last Update Date | 10/10/2023
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Provider Practice Location Address
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Address Line | 27514 W LUGONIA AVE
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City | REDLANDS
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State | CA
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Zip | 92374-1409
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Country | US
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Telephone | 857-284-9441
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 BARTON RD APT 412
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City | REDLANDS
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State | CA
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Zip | 92373-5485
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 35601
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License Number State | CA
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